| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HEALTH CARE SERVICES CORPORATION3 | 300 E. RANDOLPH ST CHICAGO, IL 60601 | FOUR EVER LIFE INS CO. | — | $7K | $7K | 8.00% |
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 | 2,718 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 278 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 47 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 3,043 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | HEALTH CARE SERVICE CORPORATION, A MUTUAL LEGAL RESERVE COMPANY | 7,551 | $663K |
| Dental | FOUR EVER LIFE INS CO. | 18 | $92K |
| Vision | VISION SERVICE PLAN | 2,017 | $379K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 2,718 | $523K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 2,718 | $932K |
| Prescription drug | HEALTH CARE SERVICE CORPORATION, A MUTUAL LEGAL RESERVE COMPANY | 7,551 | $571K |
| Stop-loss / reinsurancereinsurance | HEALTH CARE SERVICE CORPORATION, A MUTUAL LEGAL RESERVE COMPANY | 7,551 | $571K |
| Other(3 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 2,718 | $240K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 7,551 | — |
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 comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.
Multiple-employer welfare arrangement. Specific regulatory and compliance context; specific consultant niche.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.