| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| SKODINSKI INSURANCE LLC3 | 2212 LINCOLN WAY WEST MISHAWAKA, IN 465441617 | HUMANA INSURANCE COMPANY | $125K | — | $125K | 8.21% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ANTHEM INSURANCE CO. EIN 35-0781558 NONE | Contract Administrator; Direct payment from the plan; Other services; Recordkeeping and information management (computing, tabulating, data processing, etc.); Float revenue; Claims processing Service code 12 | — | $373K |
| BENESYS, INC. EIN 38-2383171 NONE | Direct payment from the plan; Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.); Claims processing Service code 12 | — | $284K |
| TIC INTERNATIONAL CORPORATION EIN 13-2600875 NONE | Direct payment from the plan; Accounting (including auditing); Plan Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.); Contract Administrator Service code 10 | — | $121K |
| HINES & ASSOCIATES, INC. NONE | Direct payment from the plan; Consulting (general) Service code 16 | 115 EAST HIGHLAND AVENUE ELGIN, IL 60120 | $117K |
| SCREENSAFE INC. NONE | Direct payment from the plan; Other services Service code 49 | 2708 CATON FARM ROAD JOLIET, IL 60435 | $28K |
| MACQUIRE INVESTMENT MANAGEMENT NONE | Direct payment from the plan; Investment management Service code 28 | 2005 MARKET STREET PHILADELPHIA, PA 19103 | $19K |
| BENDA, GRACE, STULZ & COMPANY PC EIN 38-2284921 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $19K |
| TRADE SOLUTIONS NONE | Participant communication; Direct payment from the plan; Copying and duplicating Service code 36 | PO BOX 1318 CLARKSTON, MI 48347 | $14K |
| FOSTER & FOSTER NONE | Actuarial; Direct payment from the plan; Consulting (general) Service code 11 | 184 SHUMAN BLVD SUITE 305 NAPERVILLE, IL 60563 | $11K |
| NEW AVENUES NONE | Direct payment from the plan; Other services Service code 49 | PO BOX 360 SOUTH BEND, IN 46624 | $10K |
| URDA PROFESSINAL CORPORATION EIN 35-6269273 NONE | Legal; Direct payment from the plan Service code 29 | — | $10K |
| MORGAN STANLEY SMITH BARNEY LLC EIN 26-4310632 NONE | Investment advisory (plan); Other investment fees and expenses; Direct payment from the plan Service code 27 | — | $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 | 947 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 299 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,246 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Stop-loss / reinsurancereinsurance | UNION LABOR LIFE INSURANCE COMPANY | 1,018 | $1.6M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,018 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.