No brokers reported on this filing.
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF ILLINOIS EIN 36-0123661 TPA | Claims processing Service code 12 | — | $76K |
| BLUE CROSS BLUE SHIELD OF MICHIGAN EIN 38-2069753 TPA | Claims processing Service code 12 | — | $58K |
| NGS AMERICAN EIN 38-2259531 TPA | Claims processing Service code 12 | — | $58K |
| TRANSITIONAL REINSURANCE FEES GOVERNMENT HCR FEE | Other fees Service code 99 | — | $40K |
| NORTHERN TRUST EIN 36-1561860 TRUSTEE | Trustee (directed) Service code 25 | — | $33K |
| PLANTE MORAN EIN 38-1357951 ACCOUNTANT/AUDITOR | Accounting (including auditing) Service code 10 | — | $24K |
| PCE EIN 38-2958486 INFORMATION MANAGER | Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $11K |
| MERCER EIN 13-2834414 TPA | Claims processing Service code 12 | — | $7K |
| CAREMARK EIN 95-3382344 TPA | Claims processing Service code 12 | — | $5K |
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 | 0 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4,372 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 4,372 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 3,015 | $18K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 3,015 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Filing reports zero broker compensation on a plan over 100 participants. Likely direct-write or unreported — worth a knock.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.