| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| VERITAS RISK SERVICES3 | 3025 HIGHLAND PARKWAY SUITE 650 DOWNERS GROVE, IL 60515 | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | $76K | $0 | $76K | 4.76% |
| VERITAS RISK SERVICES3 Filed as: VERITAS RISK SERVICES - BOR | 3025 HIGHLAND PARKWAY SUITE 6 DOWNERS GROVE, IL 60515 | COMBINED INSURANCE COMPANY OF AMERICA | $18K | $0 | $18K | 7.30% |
| VERITAS RISK SERVICES3 Filed as: VERITAS RICK SERVICES | 3025 HIGHLAND PARKWAY SUITE 6 DOWNERS GROVE, ID 60515 | COMBINED INSURANCE COMPANY OF AMERICA | $9K | $0 | $9K | 7.35% |
| VERITAS RISK SERVICES3 Filed as: VERITAS RISK SERVICES - BOR | 3025 HIGHLAND PARKWAY SUITE 6 DOWNERS GROVE, IL 60515 | COMBINED INSURANCE COMPANY OF AMERICA | $206 | $0 | $206 | 7.31% |
| VERITAS RISK SERVICES3 Filed as: VERITAS RISK SERVICES - BOR | 3025 HIGHLAND PARKWAY SUITE 6 DOWNERS GROVE, IL 60515 | COMBINED INSURANCE COMPANY OF AMERICA | $107 | $0 | $107 | 7.03% |
| VERITAS RISK SERVICES3 | 3025 HIGHLAND PARKWAY UNIT 650 DOWNERS GROVE, IL 60515 | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | $71 | $0 | $71 | 5.04% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UNITED HEALTH CARE EIN 41-1321939 NONE | Claims processing Service code 12 | — | $1.2M |
| DELTA DENTAL OF IL EIN 36-2612058 NONE | Claims processing Service code 12 | — | $82K |
| EMPLOYEE RESOURCE CENTER EIN 39-1743189 NONE | Other services Service code 49 | — | $64K |
| EXPRESS SCRIPTS EIN 22-3461740 NONE | Claims processing Service code 12 | — | $62K |
| BENEFIT ADVANTAGE EIN 39-2023593 NONE | Claims processing Service code 12 | — | $36K |
| WILLIS TOWERS WATSON EIN 23-1159360 NONE | Actuarial Service code 11 | — | $18K |
| SCHENCK SC EIN 39-1173131 NONE | Accounting (including auditing) Service code 10 | — | $13K |
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 | 1,870 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1,772 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 3,642 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | UNITEDHEALTH GROUP, INC. | 3,642 | $5.4M |
| Vision(4 contracts) | COMBINED INSURANCE COMPANY OF AMERICA | 2,625 | $378K |
| Life insurance | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | 3,642 | $1.6M |
| Long-term disability | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | 3,642 | $1.6M |
| Other | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | 1,984 | $1K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 3,642 | — |
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."
No prospect flags tripped on this filing.