| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH USA LLC | 540 W MADISON STREET, 12TH FL CHICAGO, IL 60661 | BLUECROSS BLUESHIELD OF ILLINOIS | $86K | $0 | $86K | 3.96% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH JCS INC | 540 W MADISON STREET, 12TH FL CHICAGO, IL 60661 | DEARBORN LIFE INSURANCE COMPANY | $3K | $0 | $3K | 10.03% |
| MICHAEL BLOCK3 | 41 ARUM CT ST AUGUSTINE, FL 32095 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $68 | $0 | $68 | 1.59% |
| SUMITOMO LIFE INSURANCE AGENCY3 | 565 5TH AVE NEW YORK, NY 10017 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $56 | $0 | $56 | 1.31% |
| JANTELLE LAVONNE BONNER3 | 99 N POST OAK LANE, APT 5302 HOUSTON, TX 77024 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $45 | $0 | $45 | 1.05% |
| REBECCA STERNBERG3 | 374 MILFORD RD DEERFIELD, IL 60015 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $22 | $0 | $22 | 0.51% |
| ELAISIUS BONNER3 | 974 ROSEFIELD LANE AURORA, IL 60504 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $8 | $0 | $8 | 0.19% |
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 | 106 | 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) | 106 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUESHIELD OF ILLINOIS | 236 | $2.2M |
| Dental | BLUECROSS BLUESHIELD OF ILLINOIS | 236 | $2.2M |
| Vision | DEARBORN LIFE INSURANCE COMPANY | 113 | $26K |
| Life insurance | DEARBORN LIFE INSURANCE COMPANY | 113 | $26K |
| Short-term disability | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 7 | $4K |
| Other(2 contracts, 2 carriers) | DEARBORN LIFE INSURANCE COMPANY | 113 | $30K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 236 | — |
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.