| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ORMA R SMITH III3 Filed as: ORMA RINEHART SMITH | — | BLUECROSS BLUESHIELD OF ILLINOIS | $105K | — | $105K | 4.39% |
| STREAMLINE ENTERPRISES LLC3 Filed as: STREAMLINE ENTERPRISES, LLC DB | 3725 CHAMPION HILLS DRIVE SUITE 3300 MEMPHIS, TN 38125 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $10K | $501 | $10K | 13.23% |
| SMITH III, ORMA R3 | 3725 CHAMPION HILLS DRIVE SUITE 3300 MEMPHIS, TN 38125 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $109 | $109 | 0.14% |
| 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 | $314 | $9K | 17.34% |
| SMITH III, ORMA R3 | 3725 CHAMPION HILLS DRIVE SUITE 3300 MEMPHIS, TN 38125 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $83 | $83 | 0.17% |
| STREAMLINE ENTERPRISES LLC3 Filed as: STREAMLINE ENTERPRISES, LLC DB | 3725 CHAMPION HILLS DRIVE SUITE 3300 MEMPHIS, TN 38125 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $9K | $303 | $9K | 20.29% |
| SMITH III, ORMA R3 | 3725 CHAMPION HILLS DRIVE SUITE 3300 MEMPHIS, TN 38125 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $66 | $66 | 0.14% |
| STREAMLINE ENTERPRISES LLC3 | 3725 CHAMPION HILLS DRIVE SUITE 3300 MEMPHIS, TN 38125 | AMERITAS LIFE INSURANCE CORP. | $2K | — | $2K | 6.97% |
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 | 238 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 5 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 15 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 258 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUESHIELD OF ILLINOIS | 348 | $2.4M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 458 | $141K |
| Vision | AMERITAS LIFE INSURANCE CORP. | 156 | $24K |
| Life insurance(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 238 | $125K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 238 | $79K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 81 | $50K |
| Other(3 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 238 | $149K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 458 | — |
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.