| 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 | $82K | $0 | $82K | 4.00% |
| 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 | 10.04% |
| MICHAEL BLOCK3 | 16619 S PINECREEK DR LOCKPORT, IL 60441 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $105 | $0 | $105 | 2.11% |
| SUMITOMO LIFE INSURANCE AGENCY3 | 1350 AVE OF THE AMERICAS NEW YORK, NY 10019 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $64 | $0 | $64 | 1.29% |
| JANTELLE LAVONNE BONNER3 | 99 N POST OAK LANE, APT 5302 HOUSTON, TX 77024 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $38 | $0 | $38 | 0.76% |
| REBECCA STERNBERG3 | 374 MILFORD RD DEERFIELD, IL 60015 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $25 | $0 | $25 | 0.50% |
| DAVID TODD WEINSTEIN3 | 7862 WEST IRLO BRONSON MEM HWY KISSIMMEE, FL 34747 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $24 | $0 | $24 | 0.48% |
| ELAISIUS BONNER3 | 974 ROSEFIELD LANE AURORA, IL 60504 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $6 | $0 | $6 | 0.12% |
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 | 230 | $2.1M |
| Dental | BLUECROSS BLUESHIELD OF ILLINOIS | 230 | $2.1M |
| Vision | DEARBORN LIFE INSURANCE COMPANY | 109 | $26K |
| Life insurance | DEARBORN LIFE INSURANCE COMPANY | 109 | $26K |
| Short-term disability | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 7 | $5K |
| Prescription drug | BLUECROSS BLUESHIELD OF ILLINOIS | 230 | $2.1M |
| Other(2 contracts, 2 carriers) | DEARBORN LIFE INSURANCE COMPANY | 109 | $31K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 230 | — |
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.