| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ASSURANCE AGENCY LTD3 | 1 CENTURY CENTER 1750 EAST GOLF ROAD OSAGE BEACH, IL 60173 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $11K | $6K | $16K | 17.82% |
| ASSURANCE AGENCY LTD3 | ONE CENTURY CENTRE 1750 E GOLF ROAD, SUITE 1100 SCHAUMBURG, IL 60173 | DEARBORN NATIONAL LIFE INSURANCE COMPANY | $7K | $2K | $9K | 20.63% |
| WELLMARK INC3 | ANCILLARY MARKETING DEPARTMENT PO BOX 10481 DES MOINES, IA 50306 | DEARBORN NATIONAL LIFE INSURANCE COMPANY | — | $2K | $2K | 5.01% |
| ASSURANCE AGENCY LTD3 | ONE CENTURY CENTRE 1750 EAST GOLF ROAD SCHAUMBURG, IL 60173 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $2K | — | $2K | 12.85% |
| COTTINGHAM & BUTLER3 Filed as: COTTINGHAM & BUTLER INS SVCS INC | PO BOX 28 DUBUQUE, IA 52004 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $2K | — | $2K | 12.20% |
| ASSURANCE AGENCY LTD3 | ONE CENTURY CENTRE 1750 EAST GOLF ROAD SCHAUMBURG, IL 60173 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $281 | — | $281 | 4.64% |
| COTTINGHAM & BUTLER3 Filed as: COTTINGHAM & BUTLER INS SVCS INC | PO BOX 28 DUBUQUE, IA 52004 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $281 | — | $281 | 4.64% |
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 | 185 | 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) | 185 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 144 | $93K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 144 | $93K |
| Life insurance(2 contracts) | AMERICAN HERITAGE LIFE INSURANCE COMPANY | 185 | $19K |
| Short-term disability(3 contracts, 2 carriers) | DEARBORN NATIONAL LIFE INSURANCE COMPANY | 185 | $65K |
| Long-term disability | DEARBORN NATIONAL LIFE INSURANCE COMPANY | 66 | $46K |
| Stop-loss / reinsurancereinsurance(2 contracts) | QBE INSURANCE CORPORATION | 180 | $377K |
| Other(2 contracts) | AMERICAN HERITAGE LIFE INSURANCE COMPANY | 185 | $19K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 185 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.