| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MESIROW INSURANCE SERVICES INC3 | 353 N CLARK STREET CHICAGO, IL 60654 | BLUE CROSS BLUE SHIELD OF ILLINOIS | $272K | $11K | $284K | 3.09% |
| MESIROW INSURANCE SERVICES INC3 Filed as: MESIROW INSURANCE SERVICES | 353 N CLARK STREET SUITE 400 CHICAGO, IL 60654 | METROPOLITAN LIFE INSURANCE COMPANY | $5K | $1K | $6K | 1.67% |
| MESIROW INSURANCE SERVICES INC | 353 N CLARK STREET SUITE 400 - ACCT DEPT - SCOTT H CHICAGO, IL 60654 | METROPOLITAN LIFE INSURANCE COMPANY | $345 | $0 | $345 | 0.09% |
| MESIROW INSURANCE SERVICES INC | 353 N CLARK STREET SUITE 400 CHICAGO, IL 60654 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $118 | $118 | 0.03% |
| MESIROW INSURANCE SERVICES INC3 | 353 N CLARK STREET CHICAGO, IL 60654 | KAISER FOUNDATION HEALTH PLAN INC | $8K | $0 | $8K | 2.62% |
| MESIROW INSURANCE SERVICES INC3 | 353 N CLARK STREET CHICAGO, IL 60654 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $19K | $0 | $19K | 7.99% |
| MESIROW INSURANCE SERVICES INC3 | 353 N CLARK STREET CHICAGO, IL 60654 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $32K | $4K | $36K | 16.62% |
| MESIROW INSURANCE SERVICES INC3 | 353 N CLARK STREET CHICAGO, IL 60654 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $12K | $2K | $15K | 11.75% |
| MESIROW INSURANCE SERVICES INC3 | 353 N CLARK STREET CHICAGO, IL 60654 | UNUM LIFE INSURANCE SERVICES INC | $8K | $1K | $9K | 11.75% |
| MESIROW INSURANCE SERVICES INC3 | 353 N CLARK STREET CHICAGO, IL 60654 | VISION SERVICE PLAN | $3K | — | $3K | 5.00% |
| MESIROW INSURANCE SERVICES INC3 Filed as: MESIROW INSURANCES SERVICES INC | 353 N CLARK STREEET CHICAGO, IL 60654 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $7K | $1K | $8K | 11.75% |
| MESIROW INSURANCE SERVICES INC3 | 353 N CLARK STREET CHICAGO, IL 60654 | FIRST UNUM LIFE INSURANCE COMPANY | $2K | $289 | $2K | 11.75% |
| RUEBEN WARNER ASSOCIATES, INC.3 Filed as: RUEBEN WARNER ASSOCIATES, INC | 1655 RICHMOND AVENUE STATEN ISLAND, NY 10314 | FEDERAL INSURANCE COMPANY | $0 | $0 | $0 | — |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON BENEFIT COMPANIES LLC | 444 W.47TH STREET KANSAS CITY, MO 64112 | FEDERAL INSURANCE COMPANY | $0 | $0 | $0 | — |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| PAYFLEX SYSTEMS USA EIN 91-1774434 FSA SERVICES | Contract Administrator Service code 13 | — | $52K |
| CIGNA HEALTH AND LIFE INSURNACE CO. EIN 59-1031071 ASO SERVICES | Contract Administrator; Claims processing Service code 12 | — | $35K |
| UNUM LIFE INSURANCE CO. OF AMERICA EIN 01-0278678 CONTRACT ADMINISTRATOR | Contract Administrator; Claims processing Service code 12 | — | $30K |
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 | 967 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 17 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 988 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF ILLINOIS | 1,639 | $9.4M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 19 | $241K |
| Vision | VISION SERVICE PLAN | 580 | $68K |
| Life insurance(3 contracts, 3 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 956 | $528K |
| Short-term disability | FIRST UNUM LIFE INSURANCE COMPANY | 300 | $17K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,234 | $124K |
| Other(5 contracts, 4 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 968 | $376K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,639 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.