| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH & MCLENNAN DBA ASSURANCE | 20 N. MARTINGALE RD., STE. 100 SCHAUMBURG, IL 60173 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $3K | $651 | $4K | 5.89% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS, INC. | 422 WAUPONSEE ST. MORRIS, IL 60450 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $3K | $0 | $3K | 4.95% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: ASSURANCE, MARSH & MCLENNAN AGCY | 20 N. MARTINGALE RD., STE. 100 SCHAUMBURG, IL 60173 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $7K | $427 | $7K | 15.98% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS, INC. | 422 WAUPONSEE ST. MORRIS, IL 60450 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $2K | $213 | $2K | 5.49% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: ASSURANCE, MARSH & MCLENNAN AGCY | 20 N. MARTINGALE RD., STE. 100 SCHAUMBURG, IL 60173 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $3K | $178 | $3K | 16.04% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS, INC. | 422 WAUPONSEE ST. MORRIS, IL 60450 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $850 | $89 | $939 | 5.52% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: ASSURANCE, MARSH & MCLENNAN AGCY | 20 N. MARTINGALE RD., STE. 100 SCHAUMBURG, IL 60173 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $2K | $0 | $2K | 15.00% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS, INC. | 422 WAUPONSEE ST. MORRIS, IL 60450 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $823 | $0 | $823 | 5.00% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: ASSURANCE, MARSH & MCLENNAN AGCY | 20 N. MARTINGALE RD., STE. 100 SCHAUMBURG, IL 60173 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $1K | $116 | $1K | 15.24% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS, INC. | 422 WAUPONSEE ST. MORRIS, IL 60450 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $486 | $42 | $528 | 5.43% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: ASSURANCE, MARSH & MCLENNAN AGCY | 20 N. MARTINGALE RD., STE. 100 SCHAUMBURG, IL 60173 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $853 | $57 | $910 | 13.81% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS, INC. | 422 WAUPONSEE ST. MORRIS, IL 60450 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $330 | $21 | $351 | 5.33% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: ASSURANCE, MARSH & MCLENNAN AGCY | 20 N. MARTINGALE RD., STE. 100 SCHAUMBURG, IL 60173 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $617 | $48 | $665 | 14.60% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS, INC. | 422 WAUPONSEE ST. MORRIS, IL 60450 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $228 | $18 | $246 | 5.40% |
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 | 112 | 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) | 112 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 143 | $660K |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 91 | $69K |
| Vision | RELIANCE STANDARD LIFE INSURANCE COMPANY | 149 | $8K |
| Life insurance | RELIANCE STANDARD LIFE INSURANCE COMPANY | 160 | $17K |
| Short-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 37 | $16K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 160 | $44K |
| Other(4 contracts) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 160 | $38K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 160 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.