| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| THE SEGAL COMPANY3 | 101 N. WACKER DRIVE, SUITE 500 CHICAGO, IL 60606 | THE UNION LABOR LIFE INSURANCE COMPANY | $10K | $0 | $10K | 1.08% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| COMMUNITY INSURANCE COMPANY EIN 31-1440175 NONE | Other services; Recordkeeping and information management (computing, tabulating, data processing, etc.); Float revenue; Claims processing; Contract Administrator Service code 12 | — | $7.2M |
| ANTHEM HEALTH PLANS OF KENTUCKY, IN EIN 61-1237516 NONE | Float revenue; Recordkeeping and information management (computing, tabulating, data processing, etc.); Claims processing; Contract Administrator; Other services Service code 12 | — | $2.2M |
| BRIDGEWAY BENEFIT TECHNOLOGIES LLC EIN 52-1796473 NONE | Recordkeeping fees; Direct payment from the plan; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $973K |
| EPLAN LLC EIN 22-3720767 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $919K |
| THE SEGAL COMPANY (MIDWEST), INC. EIN 13-1975125 NONE | Actuarial; Consulting (general); Direct payment from the plan Service code 11 | — | $741K |
| REINHART BOERNER VAN DEUREN S.C. EIN 39-1126909 NONE | Legal; Direct payment from the plan Service code 29 | — | $680K |
| DELTA DENTAL OF OHIO EIN 31-0685339 NONE | Contract Administrator; Claims processing; Direct payment from the plan Service code 12 | — | $600K |
| SLEVIN & HART P.C EIN 52-1708613 NONE | Legal; Direct payment from the plan Service code 29 | — | $389K |
| SPECTRUM PRINTING & DESIGN EIN 31-1023172 NONE | Participant communication; Copying and duplicating; Direct payment from the plan Service code 36 | — | $321K |
| WILLIAM EVANS EIN 31-6173363 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $258K |
| REDCARD SYSTEMS LLC EIN 20-5388701 NONE | Other services; Direct payment from the plan Service code 49 | — | $251K |
| KATY MACIK EIN 31-6173363 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $223K |
| WILLIAM MCMANUS EIN 31-6173363 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $180K |
| MELISSA STEED EIN 31-6173363 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $179K |
| RICHARD MAINS EIN 31-6173363 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $175K |
| VISION SERVICE PLAN EIN 31-0725743 NONE | Direct payment from the plan; Claims processing; Contract Administrator Service code 12 | — | $174K |
| ERICA BASSMAN EIN 31-6173363 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $138K |
| SHARI LEWIS EIN 31-6173363 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $111K |
| ERIC MUELLER EIN 31-6173363 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $109K |
| 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 | — | $107K |
| AISHIA FULCHER EIN 31-6173363 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $91K |
| CARL LOMBARDO EIN 31-6173363 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $89K |
| GRAHAM WATSON EIN 31-6173363 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $88K |
| JODI LONG EIN 31-6173363 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $87K |
| SIKICH LLP EIN 36-3168081 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $87K |
| ERIN GEBHARDT EIN 31-6173363 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $87K |
| REBECCA CROW EIN 31-6173363 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $80K |
| MISTY JO KESSLER EIN 31-6173363 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $79K |
| ANITA GARBER EIN 31-6173363 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $75K |
| SHEILA OAKS EIN 31-6173363 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $74K |
| ANN RUDD EIN 31-6173363 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $74K |
| MARI MADDEN EIN 31-6173363 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $74K |
| BLUE CROSS BLUE SHIELD OF MICHIGAN EIN 38-2069753 NONE | Other services; Float revenue; Contract Administrator; Claims processing; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | — | $74K |
| CHARLOTTE KYLE EIN 31-6173363 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $73K |
| PAULA ROYSE EIN 31-6173363 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $71K |
| JOYCE WOOSLEY EIN 31-6173363 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $70K |
| KARRIE SHRINER EIN 31-6173363 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $70K |
| BRANDY MULLENIX EIN 31-6173363 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $69K |
| PATRICE HILL EIN 31-6173363 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $69K |
| HEATHER MILLER EIN 31-6173363 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $67K |
| CHRISTINA STAATS EIN 31-6173363 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $66K |
| CARMEN STEINBARGER EIN 31-6173363 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $65K |
| APRIL STEPHENS EIN 31-6173363 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $64K |
| ANGELA STASTNY EIN 31-6173363 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $63K |
| SEGAL SELECT INSURANCE SERVICES INC EIN 46-0619194 NONE | Insurance brokerage commissions and fees; Insurance agents and brokers Service code 22 | — | $62K |
| VICKIE JOHNSON EIN 31-6173363 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $62K |
| MARY CURTIS EIN 31-6173363 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $60K |
| DEA CLARK EIN 31-6173363 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $60K |
| TRACY SMITH EIN 31-6173363 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $58K |
| EXPRESS SCRIPTS, INC. EIN 43-1420563 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $55K |
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 | 49,260 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 393 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 49,653 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | SYMETRA LIFE INSURANCE COMPANY | 50,835 | $0 |
| Stop-loss / reinsurancereinsurance | THE UNION LABOR LIFE INSURANCE COMPANY | 2,867 | $929K |
| Other | SYMETRA LIFE INSURANCE COMPANY | 50,835 | $0 |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 50,835 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.