| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| JOHN BLAUDOW3 Filed as: JOHN JARED BLAUDOW | — | HEALTH ALLIANCE MEDICAL PLANS | $38K | — | $38K | 2.49% |
| ROGERS BENEFIT GROUP INC3 | 12222 MERIT DRIVE #1780 DALLAS, TX 75251 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $7K | — | $7K | 5.00% |
| ASSUREDPARTNERS3 Filed as: DIMOND BROTHERS INSURANCE LLC | 1806 WOODFIELD DRIVE PO BOX 723 SAVOY, IL 61874 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $4K | — | $4K | 3.00% |
| ASSUREDPARTNERS3 Filed as: DIMOND BROS INSURANCE LLC | PO BOX 1090 PARIS, IL 61944 | STANDARD INSURANCE COMPANY | $5K | — | $5K | 4.99% |
| ASSUREDPARTNERS3 Filed as: DIMOND BROS INSURANCE LLC | PO BOX 1090 PARIS, IL 61944 | STANDARD INSURANCE COMPANY | $7K | — | $7K | 10.03% |
| ASSUREDPARTNERS3 Filed as: DIMOND BROS INSURANCS LLC | PO BOX 1090 PARIS, IL 61944 | STANDARD INSURANCE COMPANY | $836 | — | $836 | 2.00% |
| ASSUREDPARTNERS3 Filed as: DIMOND BROS INSURANCE LLC | PO BOX 1090 PARIS, IL 61944 | STANDARD INSURANCE COMPANY | $2K | — | $2K | 12.89% |
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 | 288 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 8 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 1 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 297 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HEALTH ALLIANCE MEDICAL PLANS | 201 | $1.5M |
| Dental(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 245 | $175K |
| Vision | VISION SERVICE PLAN | 166 | $28K |
| Life insurance | STANDARD INSURANCE COMPANY | 282 | $100K |
| Short-term disability | STANDARD INSURANCE COMPANY | 83 | $15K |
| Long-term disability | STANDARD INSURANCE COMPANY | 282 | $71K |
| Other(2 contracts) | STANDARD INSURANCE COMPANY | 282 | $171K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 282 | — |
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."
No prospect flags tripped on this filing.