Filings through .
History & trajectory Charts need 2 or more years. This plan has 10 years on file. Pro shows premium, premium per covered life, covered lives and carrier and broker share for every year.
See pricingThe primary broker changed. The plan may listen to a new pitch.
The Schedule A insurance contracts show who carries the risk, for which benefits and for how many people.
| Carrier | Coverage | Premium |
|---|---|---|
Broker: Hub International Midwest Limited PPO | PPO | |
Stop-loss | Stop-loss |
Premium, covered lives, retention, contract number and renewal month for each carrier are on Pro.
See premium, retention and renewal dates for 2 contracts with Pro. Pro is free for 7 days and then costs $49 a month.
These benefits are declared on the Form 5500 main form. A ✓ means the benefit also has a Schedule A insurance contract. Without one, plan assets or a Schedule C TPA fund the benefit.
The plan reports several different headcounts depending on which form you read. Each one measures a different slice of the population.
| Active participants | 1,234 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 328 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,562 | Active, retired or separated, and beneficiaries. Dependents are not counted. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Stop-loss / reinsurancereinsurance | STEALTH PARTNER GROUP | 1,174 | $475K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,174 | - |
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 instead of this filer's headcount. We show the row, but it does not count the people in this plan.
Brokers paid through Schedule A and service providers paid through Schedule C.
| Broker | Commissions |
|---|---|
Carrier: Humana Insurance Company | |
Carrier: Humana Insurance Company |
Commissions, fees, broker address and the carrier each broker is paid through are on Pro.
| Provider | Services | Address | Compensation |
|---|---|---|---|
| EVERSIDE HEALTH LLC EIN 45-3449075 NONE | Direct payment from the plan; Other services Service code 49 | — | $1.3M |
| AETNA EIN 06-6033492 NONE | Contract Administrator Service code 13 | — | $556K |
| TIC MIDWEST LLC EIN 13-2600875 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.); Direct payment from the plan; Plan Administrator; Accounting (including auditing); Contract Administrator Service code 10 | — | $147K |
| MEYERS GLAROS LLC NONE | Other services Service code 49 | 8605 BROADWAY MERRIVILLE, IN 46410 | $100K |
| MAY OBERFELL LORBER EIN 35-0914880 NONE | Legal; Direct payment from the plan Service code 29 | — | $91K |
| SCREENSAFE, INC NONE | Other services; Direct payment from the plan Service code 49 | 2708 CATON RD JOLIET, IL 60435 | $88K |
| NEW AVENUES INC NONE | Other services; Direct payment from the plan Service code 49 | PO BOX 260 SOUTH BEND, IN 46624 | $29K |
| BENDA, GRACE, STULZ & COMPANY P.C. EIN 38-2284921 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $22K |
| FOSTER & FOSTER NONE | Actuarial; Direct payment from the plan Service code 11 | 184 SHUMAN BLVD, STE 305 NAPERVILLE, IL 60563 | $8K |
| MACQUIRE INVESTMENT MGMT | Investment management; Direct payment from the plan Service code 28 | 2005 MARKET STREET PHILADELPHIA, PA 19103 | $0 |
| MORGAN STANLEY SMITH BARNEY LLC EIN 26-4310632 5000 | Direct payment from the plan; Investment advisory (plan); Other investment fees and expenses Service code 27 | — | $0 |
| SEMMA HEALTH | Legal; Direct payment from the plan Service code 29 | E WAYNE STREET, STE 400 SOUTH BEND, IN 46601 | $0 |
This section shows how the plan is funded and what that means for risk.
Welfare charges, retention and retention rate (the carrier margin on this plan) are on Pro.
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10 filings · 2016 to 2025