| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| RELATION INSURANCE INC3 Filed as: RELATION INS. SVS. GREAT LAKES INC. | 300 SOUTH WACKER DRIVE, SUITE 1000 CHICAGO, IL 60606 | BLUECROSS BLUESHIELD OF ILLINOIS | $89K | $0 | $89K | 3.52% |
| KAMM INSURANCE GROUP3 Filed as: KAMM INSURANCE GROUP, INC. | UNKNOWN NILE, IL 60714 | BLUECROSS BLUESHIELD OF ILLINOIS | $11K | $923 | $12K | 0.46% |
| RELATION INSURANCE INC3 Filed as: RELATION INS. SVS. GREAT LAKES INC. | 300 SOUTH WACKER DRIVE, SUITE 1000 CHICAGO, IL 60606 | DEARBORN LIFE INSURANCE COMPANY | $8K | $0 | $8K | 10.11% |
| RELATION INSURANCE SERVICES OF CA3 Filed as: RELATION INSURANCE SERVICES, INC. | PO BOX 516624 LOS ANGELES, CA 90051 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $5K | $0 | $5K | 6.28% |
| RELATION INSURANCE SERVICES OF CA3 Filed as: RELATION INSURANCE SERVICES, INC. | 2290 HUNTINGTON DRIVE, SUITE 200 SAN MARINO, CA 91108 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $490 | $490 | 0.68% |
| RELATION INSURANCE SERVICES OF CA3 Filed as: RELATION INSURANCE SERVICES, INC. | PO BOX 516624 LOS ANGELES, CA 90051 | UNUM INSURANCE COMPANY | $420 | $0 | $420 | 15.02% |
| RELATION INSURANCE SERVICES OF CA3 Filed as: RELATION INSURANCE SERVICES, INC. | 2290 HUNTINGTON DRIVE, SUITE 200 SAN MARINO, CA 91108 | UNUM INSURANCE COMPANY | $0 | $30 | $30 | 1.07% |
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 | 122 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 122 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUESHIELD OF ILLINOIS | 287 | $2.5M |
| Dental | BLUECROSS BLUESHIELD OF ILLINOIS | 287 | $2.5M |
| Vision | DEARBORN LIFE INSURANCE COMPANY | 174 | $80K |
| Life insurance | DEARBORN LIFE INSURANCE COMPANY | 174 | $80K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 99 | $72K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 99 | $72K |
| Prescription drug | BLUECROSS BLUESHIELD OF ILLINOIS | 287 | $2.5M |
| Other(2 contracts, 2 carriers) | DEARBORN LIFE INSURANCE COMPANY | 174 | $83K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 287 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.