| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LARRY LUCCO3 | 120 EXECUTIVE DR HIGHLAND, IL 62249 | METROPOLITAN LIFE INSURANCE COMPANY | $8K | — | $8K | 13.66% |
| NFP INSURANCE SERVICES INC3 Filed as: NFP INS SERVICES | 1250 S CAPITAL OF TEXAS HW STE 125 AUSTIN, TX 78746 | METROPOLITAN LIFE INSURANCE COMPANY | $494 | — | $494 | 0.85% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| PROFESSIONAL BENEFIT ADMINISTRATORS EIN 36-3384135 NONE | Claims processing; Contract Administrator; Direct payment from the plan; Consulting (general) Service code 12 | — | $402K |
| EMPLOYEE 1 EIN 30-0088171 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $131K |
| EMPLOYEE 2 EIN 30-0088171 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $116K |
| SEGAL COMPANY EIN 13-1975125 NONE | Direct payment from the plan; Consulting (general); Actuarial Service code 11 | — | $103K |
| EMPLOYEE 3 EIN 30-0088171 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $96K |
| MIDWEST REGION HEALTH & SAFETY FUND EIN 37-1384481 NONE | Direct payment from the plan; Other services Service code 49 | — | $88K |
| EMPLOYEE 4 EIN 30-0088171 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $74K |
| DELTA DENTAL EIN 36-2612058 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $63K |
| HEALTH PLAN SYSTEMS EIN 01-0589640 NONE | Other services; Direct payment from the plan Service code 49 | — | $49K |
| MEDICAL COST MANAGEMENT EIN 36-3445315 NONE | Direct payment from the plan; Other services Service code 49 | — | $42K |
| EMPLOYEE RESOURCE SYSTEMS INC EIN 36-3867645 NONE | Direct payment from the plan; Other services Service code 49 | — | $40K |
| CAVANAGH & O'HARA LLP EIN 37-1259635 NONE | Legal; Direct payment from the plan Service code 29 | — | $35K |
| SOUTH SIDE BANK EIN 37-0524830 NONE | Direct payment from the plan; Custodial (securities) Service code 19 | — | $32K |
| CHICAGO EQUITY PARTNERS EIN 36-4338679 NONE | Investment management; Investment management fees paid directly by plan Service code 28 | — | $30K |
| ROCKWOOD CAPITAL ADVISORS EIN 43-1775815 NONE | Investment management fees paid directly by plan; Investment management Service code 28 | — | $27K |
| BAUM SIGMAN AUERBACH & NEUMAN LTD EIN 36-2744057 NONE | Legal; Direct payment from the plan Service code 29 | — | $24K |
| ROMOLO & ASSOCIATES EIN 37-1077733 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $24K |
| SAVRX EIN 47-0527013 NONE | Direct payment from the plan; Other services Service code 49 | — | $23K |
| MARQUETTE & ASSOCIATES EIN 36-3485298 NONE | Direct payment from the plan; Investment advisory (plan) Service code 27 | — | $15K |
| HFN LLC NONE | Other services; Direct payment from the plan Service code 49 | 333 E BUTTERFIELD ROAD, 5TH FLOOR LOMBARD, IL 60148 | $12K |
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 | 1,876 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 12 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 1,888 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 1,972 | $58K |
| Stop-loss / reinsurancereinsurance | THE UNION LABOR LIFE INSURANCE COMPANY | 1,839 | $383K |
| Other | METROPOLITAN LIFE INSURANCE COMPANY | 1,972 | $58K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,972 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.