| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MESIROW INSURANCE SERVICES INC3 Filed as: MESIROW INSURANCE INC | 353 N. CLARK ST. CHICAGO, IL 60654 | HCC LIFE INSURANCE COMPANY | $15K | — | $15K | 15.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUECROSS BLUESHIELD OF IL EIN 36-1236610 NONE | Claims processing; Other insurance fees and expenses Service code 12 | — | $1.3M |
| FRANCZEK RADELET P.C. EIN 36-3924177 NONE | Legal Service code 29 | — | $298K |
| MEDICAL COST MANAGEMENT CORPORATION EIN 36-3445315 NONE | Other services Service code 49 | — | $157K |
| GREGORIO MARCO EIN 36-4028033 NONE | Legal Service code 29 | — | $141K |
| JOE OHM EIN 36-2145881 EMPLOYEE | Employee (plan); Plan Administrator Service code 14 | — | $137K |
| DELTA DENTAL OF MI EIN 38-1791480 NONE | Claims processing; Contract Administrator Service code 12 | — | $120K |
| TAMMY NICOLINI EIN 36-2145881 EMPLOYEE | Employee (plan) Service code 30 | — | $107K |
| ROSE CASSARA EIN 36-2145881 EMPLOYEE | Employee (plan) Service code 30 | — | $103K |
| THE SEGAL COMPANY EIN 13-1975125 NONE | Consulting (general); Actuarial Service code 11 | — | $102K |
| GLORIA WILLIAMS EIN 36-2145881 EMPLOYEE | Employee (plan) Service code 30 | — | $94K |
| DONNA PARZYNSKI EIN 36-2145881 EMPLOYEE | Employee (plan) Service code 30 | — | $90K |
| MARY MEEHAN EIN 36-2145881 EMPLOYEE | Employee (plan) Service code 30 | — | $88K |
| SILVIA MORENO EIN 36-2145881 EMPLOYEE | Employee (plan) Service code 30 | — | $82K |
| LSV ASSET MANAGEMENT NONE | Investment management Service code 28 | 155 NORTH WACKER DRIVE, STE 4600 CHICAGO, IL 60606 | $81K |
| NEUBERGER BERMAN INV. ADVISORS NONE | Investment management Service code 28 | 190 SOUTH LASALLE STREET CHICAGO, IL 60603 | $81K |
| ALICE PRIEBE EIN 36-2145881 EMPLOYEE | Employee (plan) Service code 30 | — | $79K |
| B.I.C.C. SYSTEMS EIN 36-2852073 NONE | Consulting (general) Service code 16 | — | $71K |
| LEGACY PROFESSIONALS LLP EIN 32-0043599 NONE | Accounting (including auditing) Service code 10 | — | $65K |
| BOND BROTHERS EIN 36-2433269 NONE | Copying and duplicating Service code 36 | — | $62K |
| AMALGAMATATED BANK OF CHICAGO EIN 36-0721895 NONE | Float revenue; Custodial (securities); Investment advisory (participants) Service code 19 | — | $60K |
| MARY KERULIS EIN 36-2145881 EMPLOYEE | Employee (plan) Service code 30 | — | $47K |
| JOHNSTON DRAGON AND ASSOCIATES EIN 22-2925793 NONE | Investment advisory (plan) Service code 27 | — | $41K |
| RITA GORMAN EIN 36-2145881 EMPLOYEE | Employee (plan) Service code 30 | — | $39K |
| CHERYL MCNALLY EIN 36-2145881 EMPLOYEE | Employee (plan) Service code 30 | — | $35K |
| OPTUMRX, INC. EIN 11-2581812 NONE | Claims processing Service code 12 | — | $32K |
| EYEMED VISION CARE EIN 31-1656473 NONE | Claims processing Service code 12 | — | $23K |
| EXAM COORDINATORS NETWORK EIN 74-3248337 NONE | Other services Service code 49 | — | $20K |
| MEDICAL REVIEW INSTITUTE EIN 87-0515201 NONE | Consulting (general); Other services Service code 16 | — | $15K |
| EMPLOYEE RESOURCES SYSTEMS, INC EIN 36-3867645 NONE | Consulting (general) Service code 16 | — | $14K |
| RICHARD J WOLF AND CO EIN 36-3182363 NONE | Accounting (including auditing) Service code 10 | — | $13K |
| TRILOGY CONSULTING GROUP EIN 36-4016705 NONE | Consulting (general); Accounting (including auditing) Service code 10 | — | $13K |
| UNIVAL NONE | Other services Service code 49 | 2311 GREEN ROAD ANN ARBOR, MI 48105 | $8K |
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 | 2,370 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2,078 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 4,448 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Stop-loss / reinsurancereinsurance | HCC LIFE INSURANCE COMPANY | 375 | $102K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 375 | — |
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.
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.