| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HJ KNIGHT INTERNATIONAL3 Filed as: HJ KNIGHT INTERNATIONAL INS. AGENCY | 30 BRAINTREE HILL OFFICE PARK BRAINTREE, MA 02184 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4K | — | $4K | 4.16% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUECROSS BLUESHIELD OF IL EIN 36-1236610 NONE | Other investment fees and expenses; Claims processing; Contract Administrator Service code 12 | — | $788K |
| WENDY SKOUMAL EIN 36-2150067 EMPLOYEE | Employee (plan) Service code 30 | — | $106K |
| JOANN RODRIGUEZ EIN 36-2150067 EMPLOYEE | Employee (plan) Service code 30 | — | $104K |
| MONIKA KOLPAK EIN 36-2150067 EMPLOYEE | Employee (plan) Service code 30 | — | $99K |
| ROSE-ANN DOYIAKOS EIN 36-2150067 EMPLOYEE | Employee (plan) Service code 30 | — | $98K |
| LEE ANN MEIBORG EIN 36-2150067 EMPLOYEE | Employee (plan) Service code 30 | — | $96K |
| LEGACY PROFESSIONALS LLP EIN 32-0043599 NONE | Accounting (including auditing) Service code 10 | — | $95K |
| SEGAL CONSULTING EIN 13-1975125 NONE | Actuarial; Consulting (general) Service code 11 | — | $93K |
| MILAN DIKLICH EIN 36-2150067 EMPLOYEE | Employee (plan); Plan Administrator Service code 14 | — | $88K |
| DOUG JOHNSTON EIN 36-2150067 EMPLOYEE/TRUSTEE | Trustee (individual); Employee (plan) Service code 20 | — | $87K |
| KATHY WAGNER EIN 36-2150067 EMPLOYEE | Employee (plan) Service code 30 | — | $84K |
| WILLIAM MCINTRYE EIN 36-2150067 EMPLOYEE | Employee (plan) Service code 30 | — | $82K |
| SEAN ALLEN EIN 36-2150067 EMPLOYEE | Employee (plan) Service code 30 | — | $82K |
| JANINA CRESPO EIN 36-2150067 EMPLOYEE | Employee (plan) Service code 30 | — | $76K |
| BOZENA DENIGRIS EIN 36-2150067 EMPLOYEE | Employee (plan) Service code 30 | — | $75K |
| KATHY ANDERSON EIN 36-2150067 EMPLOYEE | Employee (plan) Service code 30 | — | $73K |
| CATERINA BONGIOVANNI EIN 36-2150067 EMPLOYEE | Employee (plan) Service code 30 | — | $71K |
| PAVILION ADVISORY GROUP EIN 04-3831795 NONE | Investment advisory (plan) Service code 27 | — | $70K |
| JOETTE HIGGS EIN 36-2150067 EMPLOYEE | Employee (plan) Service code 30 | — | $70K |
| THE NORTHERN TRUST COMPANY EIN 36-1561860 NONE | Custodial (other than securities) Service code 18 | — | $63K |
| MARGARET PHILLIPS EIN 36-2150067 EMPLOYEE | Employee (plan) Service code 30 | — | $62K |
| VISION SERVICE PLAN OF ILLINOIS EIN 20-0891619 NONE | Claims processing Service code 12 | — | $58K |
| MED-CARE MANAGMENT EIN 88-0429522 NONE | Other services Service code 49 | — | $48K |
| INNOVATIVE SOFTWARE SOLUTIONS, INC. EIN 23-2182079 NONE | Other services; Consulting (general); Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $48K |
| CHRISTINE CHELTON EIN 36-2150067 EMPLOYEE | Employee (plan) Service code 30 | — | $47K |
| OGLETREE, DEAKINS, NASH, SMOAK EIN 57-1044820 NONE | Legal Service code 29 | — | $42K |
| IR&M INVESTMENT FUND NONE | Investment management Service code 28 | 100 FEDERAL STREET, 30TH FLOOR BOSTON, MA 02110 | $42K |
| DONNA REYES EIN 36-2150067 EMPLOYEE | Employee (plan) Service code 30 | — | $38K |
| ELIZABETH BENNETT EIN 36-2150067 EMPLOYEE | Employee (plan) Service code 30 | — | $37K |
| ASHER, GITTLER & D'ALBA, LTD. EIN 36-2786883 NONE | Legal Service code 29 | — | $36K |
| LASALLE CONSULTING PARTNERS, INC. EIN 36-4030449 NONE | Consulting (general); Other services Service code 16 | — | $34K |
| MIRIAM PAGAN EIN 36-2150067 EMPLOYEE | Employee (plan) Service code 30 | — | $34K |
| EMPLOYEE RESOURCE SYSTEMS, INC. EIN 36-3867645 NONE | Other services Service code 49 | — | $30K |
| MICHAEL HOOPER EIN 36-2150067 EMPLOYEE | Employee (plan) Service code 30 | — | $27K |
| H.J. KNIGHT INTERNATIONAL EIN 04-2960092 NONE | Insurance agents and brokers; Consulting (general) Service code 16 | — | $27K |
| CHANGE HEALTHCARE SOLUTIONS EIN 20-5716594 NONE | Other services Service code 49 | — | $25K |
| PREFERRED NETWORK ACCESS, INC. EIN 36-4018433 NONE | Other services Service code 49 | — | $15K |
| FAIR HEALTH, INC. EIN 90-0524293 NONE | Other services; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $13K |
| SOMMERS & FAHRENBACH EIN 36-1796440 NONE | Copying and duplicating Service code 36 | — | $12K |
| DOWD, BLOCH, BENNETT & CERVONE EIN 36-3371377 NONE | Legal Service code 29 | — | $12K |
| OPTUM RX EIN 11-2581812 NONE | Claims processing Service code 12 | — | $9K |
| SEGAL SELECT INSURANCE SERVICES EIN 46-0619194 NONE | Insurance brokerage commissions and fees Service code 53 | — | $9K |
| INTERACTIVE HEALTH SOLUTIONS, INC. EIN 36-3798756 NONE | Other services Service code 49 | — | $8K |
| DENTAL NETWORK OF AMERICA NONE | Claims processing; Other services Service code 12 | 701 EAST 22ND STREET LOMBARD, IL 60148 | $8K |
| BMO HARRIS BANK NA EIN 36-2085229 NONE | Investment management; Investment management fees paid directly by plan; Investment management fees paid indirectly by plan; Other fees; Custodial (securities) Service code 19 | — | $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 | 1,701 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 790 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 2,491 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,684 | $93K |
| Stop-loss / reinsurancereinsurance | THE UNION LABOR LIFE INSURANCE COMPANY | 1,770 | $552K |
| Other | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,684 | $93K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,770 | — |
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.