| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BENEFITDECISIONS.COM3 Filed as: BENEFITDECISIONS INC | 125 S WACKER DRIVE SUITE 2075 CHICAGO, IL 60606 | OXFORD HEALTH INSURANCE, INC | $31K | — | $31K | 3.00% |
| BENEFITDECISIONS.COM Filed as: BENEFITDECISIONS COM | 125 S WACKER DRIVE SUITE 2075 CHICAGO, IL 60606 | BLUE CROSS BLUE SHIELD HEALTHCARE PLAN OF GEORGIA, INC. | $10K | — | $10K | 1.29% |
| CHRISTOPHER R SAMPERS3 | 2250 SATELLITE BLVD DULUTH, GA 30097 | BLUE CROSS BLUE SHIELD HEALTHCARE PLAN OF GEORGIA, INC. | $6K | — | $6K | 0.70% |
| THE PLEXUS GROUPE LLC3 | 21805 FIELD PARKWAY SUITE 300 DEER PARK, IL 60010 | BLUE CROSS BLUE SHIELD HEALTHCARE PLAN OF GEORGIA, INC. | $2K | — | $2K | 0.20% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: DANIEL WILKE | 125 S WACKER DRIVE SUITE 2075 CHICAGO, IL 60606 | CAPITAL ADVANTAGE ASSURANCE COMPANY | $11K | — | $11K | 3.25% |
| BENEFIT DECISIONS COM3 | 125 S WACKER DRIVE SUITE 2075 CHICAGO, IL 60606 | HEALTH CARE SERVICE CORPORATION | $14K | — | $14K | 4.57% |
| THE PLEXUS GROUPE LLC3 Filed as: PLEXUS GROUPE LLC | 21805 W FIELD PARKWAY SUITE 300 DEER PARK, IL 60010 | HEALTH CARE SERVICE CORPORATION | $817 | — | $817 | 0.27% |
| THE PLEXUS GROUPE LLC3 Filed as: DAN WILKE, THE PLEXUS GROUPE | 21805 W FIELD PARKWAY SUITE 300 DEER PARK, IL 60010 | HARVARD PILGRIM HEALTH CARE | $8K | — | $8K | 4.24% |
| THE PLEXUS GROUPE LLC3 | 21805 W FIELD PARKWAY SUITE 300 DEER PARK, IL 60010 | HEALTHPARTNERS INC. | $8K | — | $8K | 4.30% |
| BENEFITDECISIONS.COM3 | 125 S WACKER DRIVE SUITE 2075 CHICAGO, IL 60606 | UNITEDHEALTHCARE INSURANCE COMPANY | — | $6K | $6K | 4.96% |
| BENEFITDECISIONS.COM3 Filed as: BENEFITDECISIONS.COM INC | 125 S WACKER DRIVE SUITE 2075 CHICAGO, IL 60606 | UNITEDHEALTHCARE INSURANCE COMPANY | $7K | -$4K | $3K | 2.11% |
| THE PLEXUS GROUPE LLC3 Filed as: DAN WILKE, THE PLEXUS GROUPE | 21805 W FIELD PARKWAY SUITE 300 DEER PARK, IL 60010 | HPHC INSURANCE COMPANY | $3K | — | $3K | 4.24% |
| THE PLEXUS GROUPE LLC3 | 21805 WEST FIELD PARKWAY SUITE 300 BARRINGTON, IL 60010 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $2K | — | $2K | 6.43% |
| THE HUNKEN AGENCY, INC.3 | — | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $12 | — | $12 | 0.03% |
| THE PLEXUS GROUPE LLC3 Filed as: THE PLEXUS GROUPE, INC. | 21805 W FIELD PARKWAY SUITE 300 DEER PARK, IL 60010 | NATIONAL VISION ADMINISTRATORS, L.L.C. | $198 | — | $198 | 5.01% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH & LIFE INSURANCE COMPA EIN 59-1031071 ADMINISTRATOR | Contract Administrator Service code 13 | — | $28K |
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 | 575 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 575 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(6 contracts, 6 carriers) | OXFORD HEALTH INSURANCE, INC | 134 | $2.9M |
| Dental(2 contracts, 2 carriers) | UNITEDHEALTHCARE INSURANCE COMPANY | 575 | $158K |
| Vision(2 contracts, 2 carriers) | UNITEDHEALTHCARE INSURANCE COMPANY | 575 | $123K |
| Prescription drug(2 contracts, 2 carriers) | CAPITAL ADVANTAGE ASSURANCE COMPANY | 46 | $653K |
| Other(2 contracts, 2 carriers) | HEALTHPARTNERS INC. | 24 | $255K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 575 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.