| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BUCK GLOBAL LLC3 | PO BOX 207640 DALLAS, TX 75320 | HARTFORD LIFE AND ACCIDENT | $0 | $6K | $6K | — |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| COMMUNITY INSURANCE COMPANY EIN 31-1440175 NONE | Contract Administrator; Claims processing; Float revenue; Recordkeeping and information management (computing, tabulating, data processing, etc.); Other services Service code 12 | — | $9.1M |
| EPLAN LLC EIN 22-3720767 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $837K |
| BASYS, INC. EIN 52-1796473 NONE | Direct payment from the plan; Recordkeeping and information management (computing, tabulating, data processing, etc.); Recordkeeping fees Service code 15 | — | $726K |
| REINHART BOERNER VAN DEUREN S.C. EIN 39-1126909 NONE | Legal; Direct payment from the plan Service code 29 | — | $665K |
| DELTA DENTAL OF OHIO EIN 31-0685339 NONE | Contract Administrator; Claims processing; Direct payment from the plan Service code 12 | — | $429K |
| THE SEGAL COMPANY (MIDWEST), INC. EIN 13-1975125 NONE | Direct payment from the plan; Consulting (general); Actuarial Service code 11 | — | $428K |
| SPECTRUM PRINTING & DESIGN EIN 31-1023172 NONE | Participant communication; Direct payment from the plan; Copying and duplicating Service code 36 | — | $408K |
| HEALTH FITNESS CORPORATION EIN 41-1580506 NONE | Direct payment from the plan; Other services Service code 49 | — | $300K |
| SLEVIN & HART P.C EIN 52-1708613 NONE | Legal; Direct payment from the plan Service code 29 | — | $229K |
| JERRY EVANS EIN 31-6173363 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $222K |
| REDCARD SYSTEMS LLC EIN 20-5388701 NONE | Direct payment from the plan; Other services Service code 49 | — | $200K |
| MELISSA STEED EIN 31-6173363 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $154K |
| RICHARD MAINS EIN 31-6173363 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $149K |
| VISION SERVICE PLAN EIN 31-0725743 NONE | Claims processing; Direct payment from the plan; Contract Administrator Service code 12 | — | $136K |
| SHARI LEWIS EIN 31-6173363 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $102K |
| ERIC MUELLER EIN 31-6173363 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $101K |
| REBECCA CROW EIN 31-6173363 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $84K |
| SIKICH LLP EIN 36-3168081 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $84K |
| MADISON BUTTS EIN 31-6173363 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $83K |
| CARL LOMBARDO EIN 31-6173363 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $82K |
| JODI LONG EIN 31-6173363 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $77K |
| MARY CURTIS EIN 31-6173363 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $73K |
| LAN SOLUTIONS, INC. DBA INTRUST EIN 26-0454565 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.); Direct payment from the plan Service code 15 | — | $70K |
| ANITA GARBER EIN 31-6173363 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $67K |
| SHEILA OAKS EIN 31-6173363 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $67K |
| KARRIE SHRINER EIN 31-6173363 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $66K |
| JOYCE WOOSLEY EIN 31-6173363 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $66K |
| ANN RUDD EIN 31-6173363 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $65K |
| PAULA GODSEY EIN 31-6173363 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $62K |
| CHRISTINA STAATS EIN 31-6173363 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $59K |
| CARMEN STEINBARGER EIN 31-6173363 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $59K |
| ERICA BASSMAN EIN 31-6173363 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $59K |
| CIERRA MOON EIN 31-6173363 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $58K |
| JUANITA HILBERT EIN 31-6173363 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $58K |
| BRANDY ENGLE EIN 31-6173363 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $58K |
| PEG COLLIER EIN 31-6173363 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $55K |
| CHERRY LAVENDER EIN 31-6173363 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $55K |
| LINDA HOLLON EIN 31-6173363 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $54K |
| ROSLYN AKINS EIN 31-6173363 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $53K |
| SANDY VANCE EIN 31-6173363 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $51K |
| BRANDI ADKINS EIN 31-6173363 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $50K |
| DEA CLARK EIN 31-6173363 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $50K |
| TRUDY CAIN EIN 31-6173363 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $50K |
| TRACY SMITH EIN 31-6173363 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $50K |
| EXPRESS SCRIPTS, INC. EIN 43-1420563 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $49K |
| DIANE BARNETT EIN 31-6173363 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $48K |
| BRANDIE HARTZELL EIN 31-6173363 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $48K |
| DEBORAH PLEAK EIN 31-6173363 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $47K |
| KRISTINE HALL EIN 31-6173363 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $46K |
| DONNA SMITH EIN 31-6173363 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $42K |
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 | 36,619 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 414 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 37,033 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance(2 contracts, 2 carriers) | SYMETRA LIFE INSURANCE COMPANY | 32,175 | $1.6M |
| Stop-loss / reinsurancereinsurance | THE UNION LABOR LIFE INSURANCE COMPANY | 2,599 | $741K |
| Other(2 contracts, 2 carriers) | SYMETRA LIFE INSURANCE COMPANY | 32,175 | $1.6M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 32,175 | — |
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.