| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ORMA R SMITH III3 Filed as: ORMA RINEHART SMITH | — | BLUECROSS BLUESHIELD OF ILLINOIS | $77K | — | $77K | 3.63% |
| STREAMLINE ENTERPRISES LLC3 Filed as: STREAMLINE ENTERPRISES, LLC DB | 3725 CHAMPION HILLS DRIVE SUITE 3300 MEMPHIS, TN 38125 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $8K | — | $8K | 13.69% |
| SMITH III, ORMA R3 | 3725 CHAMPION HILLS DRIVE SUITE 3300 MEMPHIS, TN 38125 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $1K | $1K | 2.00% |
| STREAMLINE ENTERPRISES LLC3 Filed as: STREAMLINE ENTERPRISES, LLC DB | 3725 CHAMPION HILLS DRIVE SUITE 3300 MEMPHIS, TN 38125 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $8K | — | $8K | 18.00% |
| SMITH III, ORMA R3 | 3725 CHAMPION HILLS DRIVE SUITE 3300 MEMPHIS, TN 38125 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $875 | $875 | 2.00% |
| SMITH III, ORMA R3 Filed as: SMITH III, ORMA, R | 3725 CHAMPION HILLS DRIVE SUITE 3300 MEMPHIS, TN 38125 | AMERITAS LIFE INSURANCE CORP. | $845 | — | $845 | 3.49% |
| STREAMLINE ENTERPRISES LLC3 | 3725 CHAMPION HILLS DRIVE SUITE 3300 MEMPHIS, TN 38125 | AMERITAS LIFE INSURANCE CORP. | $823 | — | $823 | 3.39% |
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 | 214 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 8 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 223 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUESHIELD OF ILLINOIS | 341 | $2.1M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 467 | $108K |
| Vision | AMERITAS LIFE INSURANCE CORP. | 169 | $24K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 214 | $60K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 214 | $60K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 95 | $44K |
| Other(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 214 | $85K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 467 | — |
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.