| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ASSURANCE AGENCY LTD3 | 1750 GOLF ROAD SCHAUMBURG, IL 60173 | METROPOLITAN LIFE INSURANCE COMPANY | — | $41 | $41 | 0.00% |
| ASSURANCE AGENCY LTD3 Filed as: ASSURANCE AGENCY, LTD. | 1750 EAST GOLF ROAD SCHAUMBURG, IL 60173 | KAISER FOUNDATION HEALTH PLAN INC | $15 | — | $15 | 0.00% |
| ASSURANCE AGENCY LTD3 Filed as: ASSURANCE AGENCY | 1750 EAST GOLD ROAD SCHAUMBURG, IL 60173 | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | $17K | $8K | $25K | 6.13% |
| ASSURANCE AGENCY LTD3 Filed as: ASSURANCE AGENCY | 1750 EAST GOLD ROAD SCHAUMBURG, IL 60173 | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | $8K | $4K | $12K | 6.13% |
| ASSURANCE AGENCY LTD3 Filed as: ASSURANCE AGENCY | 1750 EAST GOLF ROAD SCHAUMBERG, IA 60173 | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | — | $688 | $688 | 2.36% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS LLC | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $2K | — | $2K | 9.28% |
| ASSURANCE AGENCY LTD3 | ONE CENTURY CENTRE 1750 EAST GOLF ROAD SCHAUMBURG, IL 60173 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $614 | — | $614 | 3.58% |
No Schedule C service providers reported on this filing.
Benefits declared on the Form 5500 main form (✓ = also has a Schedule A insurance contract; otherwise the benefit is funded out of plan assets or via a Schedule C TPA).
The plan reports several different headcounts depending on which form you read. Each one measures a different slice of the population.
| Active participants | 1,426 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 21 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 13 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,460 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUECROSS BLUESHIELD OF ILLINOIS | 2,932 | $1.9M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 4,362 | $1.5M |
| Vision | VISION SERVICE PLAN | 1,242 | $140K |
| Life insurance | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | 1,393 | $414K |
| Short-term disability | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | 1,393 | $29K |
| Long-term disability | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | 1,393 | $193K |
| Other(2 contracts, 2 carriers) | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | 1,393 | $432K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 4,362 | — |
Why the numbers differ. Form 5500 line 6 counts employees + retirees + beneficiaries; no dependents. Schedule A persons-covered counts everyone enrolled, including spouses and children, so it usually exceeds line 6 by 30-60% on a working-age workforce. The medical row is normally the broadest single line because it has the highest take-up; dental/vision/life often dip below it. Stop-loss / reinsurance contracts sometimes report the carrier's full underwriting pool rather than this filer's headcount; the row is shown for transparency but shouldn't be read as "people in this plan."
Broker comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.