| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| EVERGREEN BENEFITS GROUP3 Filed as: EVERGREEN BENEFITS GROUP, LLC | 7040 N RIDGEWAY AVE LINCOLNWOOD, IL 607122620 | UNITEDHEALTHCARE INSURANCE COMPANY | — | $64K | $64K | 8.74% |
| EVERGREEN BENEFITS GROUP3 | 7040 N RIDGEWAY AVE LINCOLNWOOD, IL 60712 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $78K | $12K | $90K | 14.48% |
| EVERGREEN BENEFITS GROUP3 | 7040 N RIDGEWAY AVE LINCOLNWOOD, IL 60712 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $13K | — | $13K | 20.83% |
| EVERGREEN BENEFITS GROUP3 | 7040 N RIDGEWAY AVE LINCOLNWOOD, IL 60712 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $11K | — | $11K | 19.38% |
| EVERGREEN BENEFITS GROUP3 | 7040 N RIDGEWAY AVE LINCOLNWOOD, IL 60712 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $10K | — | $10K | 20.94% |
| EVERGREEN BENEFITS GROUP3 | 7040 N RIDGEWAY AVE LINCOLNWOOD, IL 60712 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $9K | — | $9K | 17.48% |
| EVERGREEN BENEFITS GROUP3 | 7040 N RIDGEWAY AVE LINCOLNWOOD, IL 60712 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $10K | — | $10K | 26.90% |
| LABOW MAIA3 Filed as: LABOW HOWAWRD B | 666 DUNDEE RD STE 1603 NORTHBROOK, IL 60062 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $15 | — | $15 | 0.04% |
| STRONG JIM3 | 1305 BIRCHBARK TRAIL CAROL STREAM, IL 60188 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $5 | — | $5 | 0.01% |
| FRIAS JOHN A3 | 1913 N WASHINGTON ST WHEATON, IL 60187 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $2 | — | $2 | 0.01% |
| LABOW MAIA3 Filed as: LABOW YONI | 666 DUNDEE RD STE 1603 NORTHBROOK, IL 60062 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $1 | — | $1 | 0.00% |
| LABOW MAIA3 | 666 DUNDEE RD STE 1603 NORTHBROOK, IL 60062 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $0 | — | $0 | 0.00% |
| EVERGREEN BENEFITS GROUP3 | 7040 N RIDGEWAY AVE LINCOLNWOOD, IL 60712 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $26K | — | $26K | 71.52% |
| EVERGREEN BENEFITS GROUP3 | 7040 N RIDGEWAY AVE LINCOLNWOOD, IL 60712 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $5K | — | $5K | 17.40% |
| TACKETT BRIAN3 | 1916 SEDAN AVE OBETZ, OH 43207 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $446 | — | $446 | 1.50% |
| LOMAX KIMBERLY3 | 2102 LITHUANICA AVE EAST CHICAGO, IN 46312 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $47 | — | $47 | 0.16% |
| EVERGREEN BENEFITS GROUP3 | 7040 N RIDGEWAY AVE LINCOLNWOOD, IL 60712 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $6K | — | $6K | 21.40% |
| EVERGREEN BENEFITS GROUP3 | 7040 N RIDGEWAY AVE LINCOLNWOOD, IL 60712 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $7K | — | $7K | 25.02% |
| EVERGREEN BENEFITS GROUP3 | 7040 N RIDGEWAY AVE LINCOLNWOOD, IL 60712 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $8K | — | $8K | 29.48% |
| EVERGREEN BENEFITS GROUP3 | 7040 N RIDGEWAY AVE LINCOLNWOOD, IL 60712 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $13K | — | $13K | 54.48% |
| EVERGREEN BENEFITS GROUP3 | 7040 N RIDGEWAY AVE LINCOLNWOOD, IL 60712 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $12K | — | $12K | 60.50% |
| EVERGREEN BENEFITS GROUP3 | 7040 N RIDGEWAY AVE LINCOLNWOOD, IL 60712 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $12K | — | $12K | 72.40% |
| EVERGREEN BENEFITS GROUP3 Filed as: EVERGREEN BENEFITS GROUP, LLC | 7040 N RIDGEWAY AVE LINCOLNWOOD, IL 60712 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $9K | — | $9K | 59.20% |
| EVERGREEN BENEFITS GROUP3 | 7040 N RIDGEWAY AVE LINCOLNWOOD, IL 60712 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $8K | — | $8K | 61.08% |
| EVERGREEN BENEFITS GROUP3 | 7040 N RIDGEWAY AVE LINCOLNWOOD, IL 60712 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $3K | — | $3K | 24.57% |
| EVERGREEN BENEFITS GROUP3 | 7040 N RIDGEWAY AVE LINCOLNWOOD, IL 60712 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $1K | — | $1K | 70.02% |
| EVERGREEN BENEFITS GROUP3 | 7040 N RIDGEWAY AVE LINCOLNWOOD, IL 60712 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $1K | — | $1K | 69.98% |
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 | 1,148 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 7 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,155 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITEDHEALTHCARE INSURANCE COMPANY | 148 | $727K |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 1,714 | $622K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 1,714 | $622K |
| Life insurance(15 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 1,714 | $1.0M |
| Long-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 1,714 | $622K |
| Prescription drug | UNITEDHEALTHCARE INSURANCE COMPANY | 148 | $727K |
| Other(19 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 1,714 | $1.1M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,714 | — |
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.