| 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 | $21K | — | $21K | 15.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUECROSS BLUESHIELD OF IL EIN 36-1236610 NONE | Claims processing; Other insurance fees and expenses Service code 12 | — | $1.6M |
| THE SEGAL COMPANY EIN 13-1975125 NONE | Actuarial; Consulting (general) Service code 11 | — | $219K |
| MEDICAL COST MANAGEMENT CORPORATION EIN 36-3445315 NONE | Other services Service code 49 | — | $158K |
| FRANCZEK RADELET P.C. EIN 36-3924177 NONE | Legal Service code 29 | — | $135K |
| GREGORIO MARCO EIN 36-4028033 NONE | Legal Service code 29 | — | $132K |
| ROSE CASSARA EIN 36-2145881 EMPLOYEE | Employee (plan) Service code 30 | — | $107K |
| GLORIA WILLIAMS EIN 36-2145881 EMPLOYEE | Employee (plan) Service code 30 | — | $104K |
| LSV ASSET MANAGEMENT NONE | Investment management Service code 28 | 155 NORTH WACKER DRIVE, STE 4600 CHICAGO, IL 60606 | $95K |
| DONNA PARZYNSKI EIN 36-2145881 EMPLOYEE | Employee (plan) Service code 30 | — | $91K |
| ALICE PRIEBE EIN 36-2145881 EMPLOYEE | Employee (plan) Service code 30 | — | $90K |
| NEUBERGER BERMAN INV. ADVISORS NONE | Investment management; Soft dollars commissions Service code 28 | 190 SOUTH LASALLE STREET CHICAGO, IL 60603 | $88K |
| TAMMY NICOLINI EIN 36-2145881 EMPLOYEE | Employee (plan) Service code 30 | — | $86K |
| MARY KERULIS EIN 36-2145881 EMPLOYEE | Employee (plan) Service code 30 | — | $83K |
| BRENDA DEMING EIN 36-2145881 EMPLOYEE | Plan Administrator; Employee (plan) Service code 14 | — | $82K |
| MARY MEEHAN EIN 36-2145881 EMPLOYEE | Employee (plan) Service code 30 | — | $81K |
| EXPRESS SCRIPTS, INC. EIN 43-1420563 NONE | Claims processing; Contract Administrator Service code 12 | — | $75K |
| SYLVIA MORENO EIN 36-2145881 EMPLOYEE | Employee (plan) Service code 30 | — | $75K |
| LEGACY PROFESSIONALS LLP EIN 32-0043599 NONE | Accounting (including auditing) Service code 10 | — | $72K |
| DELTA DENTAL OF MI EIN 38-1791480 NONE | Contract Administrator; Claims processing Service code 12 | — | $69K |
| BICC SYSTEMS, INC. EIN 36-2852073 NONE | Consulting (general) Service code 16 | — | $68K |
| AMALGAMATATED BANK OF CHICAGO NONE | Soft dollars commissions; Investment management; Custodial (securities) Service code 19 | 30 NORTH LASALLE STREET CHICAGO, IL 60602 | $56K |
| MORGAN LEWIS & BOCKIUS LLP EIN 23-0891050 NONE | Legal Service code 29 | — | $54K |
| RITA GORMAN EIN 36-2145881 EMPLOYEE | Employee (plan) Service code 30 | — | $34K |
| OPTUMRX, INC. EIN 33-0441200 NONE | Claims processing; Float revenue; Other fees; Direct payment from the plan Service code 12 | — | $34K |
| MARQUETTE ASSOCIATES INC. EIN 36-3485298 NONE | Consulting (pension); Consulting (general) Service code 16 | — | $33K |
| SHADIA HERNANDEZ EIN 36-2145881 EMPLOYEE | Employee (plan) Service code 30 | — | $26K |
| EMPLOYEE RESOURCES SYSTEMS, INC EIN 36-3867645 NONE | Consulting (general) Service code 16 | — | $22K |
| EYEMED VISION CARE EIN 31-1656473 NONE | Claims processing Service code 12 | — | $22K |
| 3 POINTS, LLC EIN 01-0558031 NONE | Other services Service code 49 | — | $18K |
| DELTA DENTAL OF IL EIN 36-2612058 NONE | Contract Administrator; Claims processing Service code 12 | — | $15K |
| BOND BROTHERS EIN 36-2433269 NONE | Copying and duplicating Service code 36 | — | $14K |
| BASYS, LLC EIN 52-1796473 NONE | Other services Service code 49 | — | $14K |
| RICHARD J WOLF AND CO EIN 36-3182363 NONE | Accounting (including auditing) Service code 10 | — | $12K |
| MEDICAL REVIEW INSTITUTE EIN 87-0515201 NONE | Other services; Consulting (general) Service code 16 | — | $10K |
| EXAM COORDINATORS NETWORK EIN 95-3327434 NONE | Other services Service code 49 | — | $7K |
| GROUP ADMINISTRATORS, LTD EIN 36-3381052 NONE | Claims processing; Other fees Service code 12 | — | $6K |
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 | 2,519 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1,990 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 4,509 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Stop-loss / reinsurancereinsurance | HCC LIFE INSURANCE COMPANY | 394 | $140K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 394 | — |
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.