| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ASSURANCE AGENCY LTD3 Filed as: ASSURANCE AGENCY | 20 N. MARTIINGALE RD., STE 100 SCHAUMBURG, IL 60173 | KAISER FOUNDATION HEALTH PLAN INC | $89K | — | $89K | 5.09% |
| ASSURANCE AGENCY LTD3 Filed as: ASSURANCE AGENCY | 2280 HICKS RD, STE 500 ROLLING MEADOWS, IL 60008 | BLUE CROSS OF CALIFORNIA | $49K | — | $49K | 4.59% |
| ASSURANCE AGENCY LTD3 Filed as: ASSURANCE AGENCY | 20 N. MARTINGALE RD., STE 100 SCHAUMBURG, IL 60173 | KAISER FOOUNDATION HEALTH PLAN INC | $42K | — | $42K | 4.96% |
| ASSURANCE AGENCY LTD3 Filed as: ASSURANCE AGENCY | 20 N. MARTINGALE RD., STE 100 SCHAUMBURG, IL 60173 | GUARDIAN | $23K | — | $23K | 10.00% |
| EOI SERVICE COMPANY INC3 Filed as: EOI SERVICE CO | 1820 1ST ST., STE 400 SANTA ANA, CA 92705 | HARTFORD LIFE AND ACCIDENT | $36K | — | $36K | 16.68% |
| ASSURANCE AGENCY LTD3 Filed as: ASSURANCE AGENCY | 20 N. MARTINGALE RD., STE 100 SCHAUMBURG, IL 60173 | HARTFORD LIFE AND ACCIDENT | $19K | $1K | $21K | 9.46% |
| ASSURANCE AGENCY LTD3 Filed as: ASSURANCE AGENCY LTD. | 20 N. MARTINGALE RD., STE. 100 SCHAUMBURG, IL 60173 | VISION SERVICE PLAN | $772 | — | $772 | 7.39% |
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 | 495 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 175 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 670 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 205 | $3.7M |
| Dental | GUARDIAN | 357 | $230K |
| Vision | VISION SERVICE PLAN | 91 | $10K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 908 | $217K |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 908 | $217K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 908 | $217K |
| Other | HARTFORD LIFE AND ACCIDENT | 908 | $217K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 908 | — |
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.