| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| THE PLEXUS GROUPE LLC3 | 21805 FIELD PKWY 300 DEER PARK, IL 60010 | BLUE CROSS BLUE SHIELD OF TEXAS | $52K | — | $52K | 1.52% |
| THE PLEXUS GROUPE LLC3 | 21805 FIELD PKWY 300 DEER PARK, IL 60010 | BLUE CROSS BLUE SHIELD OF TEXAS | $10K | — | $10K | 9.26% |
| THE PLEXUS GROUPE LLC3 | 21805 FIELD PKWY 300 DEER PARK, IL 60010 | ARMADACARE | $825 | — | $825 | 1.81% |
| THE PLEXUS GROUPE LLC3 | 21805 FIELD PKWY 300 DEER PARK, IL 60010 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $2K | — | $2K | 8.39% |
| THE PLEXUS GROUPE LLC3 | 21805 FIELD PKWY 300 DEER PARK, IL 60010 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $1K | — | $1K | 8.26% |
| THE PLEXUS GROUPE LLC3 | 21805 FIELD PKWY 300 DEER PARK, IL 60010 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $1K | — | $1K | 8.27% |
| THE PLEXUS GROUPE LLC3 | 21805 FIELD PKWY 300 DEER PARK, IL 60010 | HARTFORD LIFE AND ACCIDENT | $893 | — | $893 | 24.99% |
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 | 0 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 5 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 5 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF TEXAS | 2 | $3.5M |
| Dental | BLUE CROSS BLUE SHIELD OF TEXAS | 0 | $109K |
| Vision | EYEMED VISION CARE BEHALF OF FIDELITY SECURITY LIFE INS | 1 | $0 |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 0 | $16K |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 10 | $4K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 0 | $25K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF TEXAS | 0 | $3.4M |
| Other(9 contracts, 4 carriers) | ARMADACARE | 10 | $148K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 10 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.