No brokers reported on this filing.
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ADVOCATE ILLINOIS MASONIC MED GROUP NONE | Other services Service code 49 | 3000 N. HALSTED STREET CHICAGO, IL 60657 | $367K |
| WALTER KOZIN, DDS EIN 36-2139906 EMPLOYEE | Employee (plan) Service code 30 | — | $220K |
| HARVARD MAINTENANCE NONE | Other services Service code 49 | 33 W. MONROE STREET, SUITE 2325 CHICAGO, IL 60603 | $219K |
| ESTRELLA MATYAS, MD EIN 36-2139906 EMPLOYEE | Employee (plan) Service code 30 | — | $216K |
| STANISLAW BANAS, MD EIN 36-2139906 EMPLOYEE | Employee (plan) Service code 30 | — | $212K |
| JESUS CASAS EIN 36-2139906 EMPLOYEE | Employee (plan) Service code 30 | — | $202K |
| VICTOR MUNOZ, MD EIN 36-2139906 EMPLOYEE | Employee (plan) Service code 30 | — | $198K |
| MAREK MROCZKA EIN 36-2139906 EMPLOYEE | Employee (plan) Service code 30 | — | $187K |
| MYROSLAW DYCHIY, DDS EIN 36-2139906 EMPLOYEE | Employee (plan) Service code 30 | — | $182K |
| RENATA STRZALKA EIN 36-2139906 EMPLOYEE | Employee (plan) Service code 30 | — | $161K |
| STEVEN HAMMER EIN 36-2139906 EMPLOYEE | Employee (plan) Service code 30 | — | $159K |
| RASHMI SHUKLA, DDS EIN 36-2139906 EMPLOYEE | Employee (plan) Service code 30 | — | $145K |
| JAG M. CHAWLA, DDS NONE | Other services Service code 49 | TWO SOUTH 615 AVENUE LATOURS OAKBROOK, IL 60523 | $139K |
| LEGACY PROFESSIONALS LLP EIN 32-0043599 NONE | Accounting (including auditing) Service code 10 | — | $128K |
| JOSE ROSALES EIN 36-2139906 EMPLOYEE | Employee (plan) Service code 30 | — | $126K |
| ALLAN CITTA EIN 36-2139906 EMPLOYEE | Employee (plan) Service code 30 | — | $126K |
| ANITA PEACHEY EIN 36-2139906 EMPLOYEE | Employee (plan) Service code 30 | — | $122K |
| ANN CITTA EIN 36-2139906 EMPLOYEE | Employee (plan) Service code 30 | — | $121K |
| KIMBERLY RUSCHE EIN 36-2139906 EMPLOYEE | Employee (plan) Service code 30 | — | $119K |
| SILVIA CRUZ EIN 36-2139906 EMPLOYEE | Employee (plan) Service code 30 | — | $114K |
| MORAYMA LARA EIN 36-2139906 EMPLOYEE | Employee (plan) Service code 30 | — | $108K |
| INNOVATIVE SOFTWARE SOLUTIONS, INC. EIN 23-2182079 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $101K |
| MARGARETT BROWN EIN 36-2139906 EMPLOYEE | Employee (plan) Service code 30 | — | $100K |
| SYED BASEER, MD EIN 36-2139906 EMPLOYEE | Employee (plan) Service code 30 | — | $99K |
| LISA BANK EIN 36-2139906 EMPLOYEE | Non-monetary compensation; Employee (plan) Service code 30 | — | $98K |
| SYLVIA MORENO EIN 36-2139906 EMPLOYEE | Employee (plan) Service code 30 | — | $96K |
| CAROLYN FITCH EIN 36-2139906 EMPLOYEE | Employee (plan) Service code 30 | — | $95K |
| DR. STEPHEN WISE NONE | Other services Service code 49 | 1501 S. CALIFORNIA AVENUE CHICAGO, IL 60608 | $85K |
| RACHEL HERNANDEZ EIN 36-2139906 EMPLOYEE | Employee (plan) Service code 30 | — | $83K |
| SANDRA MEJIA EIN 36-2139906 EMPLOYEE | Employee (plan); Non-monetary compensation Service code 30 | — | $80K |
| DR. TIMOTHY SALLEY NONE | Other services Service code 49 | 1811 BROADSMORE DRIVE ALGONQUIN, IL 60102 | $80K |
| BLANCA TOVAR EIN 36-2139906 EMPLOYEE | Employee (plan) Service code 30 | — | $74K |
| YOLANDA DIAZ EIN 36-2139906 EMPLOYEE | Employee (plan) Service code 30 | — | $70K |
| ZOFIA BANASIAK EIN 36-2139906 EMPLOYEE | Employee (plan) Service code 30 | — | $68K |
| TONI MCGEE EIN 36-2139906 EMPLOYEE | Employee (plan) Service code 30 | — | $68K |
| ASHER, GITTLER & D'ALBA, LTD. EIN 36-2786883 NONE | Legal Service code 29 | — | $67K |
| DR. MUKESH JAIN NONE | Other services Service code 49 | 111 N. WABASH AVENUE, SUITE 1416 CHICAGO, IL 60602 | $67K |
| SANDRA BOSQUE EIN 36-2139906 EMPLOYEE | Employee (plan) Service code 30 | — | $66K |
| LASALLE CONSULTING PARTNERS EIN 36-4030449 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $65K |
| FABIOLA SERRANO EIN 36-2139906 EMPLOYEE | Employee (plan) Service code 30 | — | $65K |
| NANCY REY EIN 36-2139906 EMPLOYEE | Employee (plan) Service code 30 | — | $64K |
| KENIA TOLEDO EIN 36-2139906 EMPLOYEE | Employee (plan) Service code 30 | — | $63K |
| ISRAEL RIVERA EIN 36-2139906 EMPLOYEE | Employee (plan) Service code 30 | — | $61K |
| CLAUDIA SANDOVAL EIN 36-2139906 EMPLOYEE | Employee (plan) Service code 30 | — | $61K |
| MARIBEL AVILA EIN 36-2139906 EMPLOYEE | Employee (plan) Service code 30 | — | $60K |
| ERNESTINA ORTEGA EIN 36-2139906 EMPLOYEE | Employee (plan) Service code 30 | — | $58K |
| ROSALIA CASTILLO EIN 36-2139906 EMPLOYEE | Employee (plan) Service code 30 | — | $55K |
| LORENA NUNEZ EIN 36-2139906 EMPLOYEE | Employee (plan) Service code 30 | — | $53K |
| MARIBEL VALLE EIN 36-2139906 EMPLOYEE | Employee (plan) Service code 30 | — | $53K |
| CARMEN PEREZ EIN 36-2139906 EMPLOYEE | Employee (plan) Service code 30 | — | $53K |
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 | 3,556 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 3,558 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | AURORA DENTRICS | 33 | $9K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 33 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.