| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| SKODINSKI INSURANCE LLC3 | 2212 LINCOLN WAY WEST MISHAWAKA, IN 46544 | HUMANA INSURANCE COMPANY | $66K | — | $66K | 4.60% |
| MACQUEEN & ASSOCIATES LLC3 | 2191 TWELVE MILE ROAD BERKLEY, MI 48072 | UNION LABOR LIFE INSURANCE COMPANY | $36K | — | $36K | 7.50% |
| SKODINSKI INSURANCE LLC3 | 2212 LINCOLN WAY W MISHAWAKA, IN 46544 | HUMANA BENEFIT PLAN OF ILLINOIS, INC. | — | — | $0 | 0.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ACTIVATE HEALTHCARE LLC NONE | Direct payment from the plan; Other services Service code 49 | 9302 N MERIDIAN, STE 385 INDIANAPOLIS, IN 46260 | $858K |
| ANTHEM INSURANCE COMPANY EIN 35-0781558 NONE | Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.); Float revenue; Other services; Claims processing; Direct payment from the plan Service code 12 | — | $496K |
| BENESYS, INC EIN 38-2383171 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.); Claims processing; Contract Administrator; Direct payment from the plan Service code 12 | — | $291K |
| TIC INTERNATIONAL CORPORATION EIN 13-2600875 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.); Accounting (including auditing); Direct payment from the plan; Contract Administrator Service code 10 | — | $124K |
| SEMMA HEALTH NONE | Direct payment from the plan; Consulting (general) Service code 16 | 100 E WAYNE STREET ELGIN, IL 60120 | $27K |
| MACQUIRE INVESTMENT MGMT NONE | Investment management; Direct payment from the plan Service code 28 | 2005 MARKET STREET PHILADELPHIA, PA 19103 | $21K |
| BENDA, GRACE, STULZ & COMPANY PC NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $19K |
| NEW AVENUES NONE | Direct payment from the plan; Other services Service code 49 | PO BOX 360 SOUTH BEND, IN 46624 | $19K |
| URDA PROFESSIONAL CORPORATION NONE | Direct payment from the plan; Legal Service code 29 | — | $16K |
| SEGAL NONE | Consulting (general); Direct payment from the plan Service code 16 | — | $15K |
| SCREENSAFE INC NONE | Direct payment from the plan; Other services Service code 49 | 2708 CATON FARM RD JOLIET, IL 60435 | $12K |
| SALUS GROUP NONE | Direct payment from the plan; Consulting (general) Service code 16 | 38221 MOUND STERING HEIGHTS, MI 48310 | $10K |
| FOSTER & FOSTER NONE | Consulting (general); Direct payment from the plan Service code 16 | 184 SHUMAN BLVD, STE 305 NAPERVILLE, IL 60563 | $8K |
| MORGAN STANLEY SMITH BARNEY LLC NONE | Direct payment from the plan; Investment advisory (plan); Other investment fees and expenses 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 | 942 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 312 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,254 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Stop-loss / reinsurancereinsurance | UNION LABOR LIFE INSURANCE COMPANY | 945 | $476K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 945 | — |
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 compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.