| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| THE SEGAL COMPANY3 | 101 NORTH WACKER DR., SUITE 500 CHICAGO, IL 60606 | THE UNION LABOR LIFE INSURANCE COMPANY | $10K | — | $10K | 1.07% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUECROSS BLUESHIELD OF IL EIN 36-1236610 NONE | Contract Administrator; Claims processing; Other insurance fees and expenses Service code 12 | — | $648K |
| THE SEGAL COMPANY EIN 13-1975125 NONE | Consulting (general); Actuarial Service code 11 | — | $223K |
| NATIONAL INVESTMENT SERVICES EIN 84-3937993 NONE | Investment management Service code 28 | — | $182K |
| WENDY SKOUMAL EIN 36-2150067 EMPLOYEE | Employee (plan) Service code 30 | — | $131K |
| ROSE-ANN DOYIAKOS EIN 36-2150067 EMPLOYEE | Employee (plan) Service code 30 | — | $128K |
| JOANN RODRIGUEZ EIN 36-2150067 EMPLOYEE | Employee (plan) Service code 30 | — | $128K |
| MILAN DIKLICH EIN 36-2150067 EMPLOYEE | Plan Administrator; Employee (plan) Service code 14 | — | $103K |
| MONIKA KOLPAK EIN 36-2150067 EMPLOYEE | Employee (plan) Service code 30 | — | $102K |
| LEGACY PROFESSIONALS LLP EIN 32-0043599 NONE | Accounting (including auditing) Service code 10 | — | $96K |
| DOUG JOHNSTON EIN 36-2150067 EMPLOYEE/TRUSTEE | Employee (plan); Trustee (individual) Service code 20 | — | $96K |
| JANINA CRESPO EIN 36-2150067 EMPLOYEE | Employee (plan) Service code 30 | — | $94K |
| CAROLYN COOK EIN 36-2150067 EMPLOYEE | Employee (plan) Service code 30 | — | $91K |
| BOZENA DENIGRIS EIN 36-2150067 EMPLOYEE | Employee (plan) Service code 30 | — | $90K |
| VISION SERVICE PLAN OF ILLINOIS EIN 20-0891619 NONE | Claims processing Service code 12 | — | $62K |
| MELISSA FURTYO EIN 36-2150067 EMPLOYEE | Employee (plan) Service code 30 | — | $47K |
| BRIDGEWAY BENEFIT TECHNOLOGIES EIN 52-1796473 NONE | Consulting (general); Recordkeeping and information management (computing, tabulating, data processing, etc.); Other services Service code 15 | — | $46K |
| VALENZ CARE EIN 36-4869660 NONE | Other services Service code 49 | — | $44K |
| DONNA REYES EIN 36-2150067 EMPLOYEE | Employee (plan) Service code 30 | — | $43K |
| WASHINGTON CAPITAL MGMT EIN 91-1163419 NONE | Investment management; Investment management fees paid directly by plan Service code 28 | — | $42K |
| MIRIAM PAGAN EIN 36-2150067 EMPLOYEE | Employee (plan) Service code 30 | — | $41K |
| OPTUM RX EIN 33-0441200 NONE | Direct payment from the plan; Other fees; Float revenue; Claims processing Service code 12 | — | $37K |
| LASALLE CONSULTING PARTNERS, INC. EIN 36-4030449 NONE | Other services; Consulting (general) Service code 16 | — | $34K |
| ASHER, GITTLER & D'ALBA, LTD. EIN 36-2786883 NONE | Legal Service code 29 | — | $31K |
| STRATEGIC CAPITAL INV ADVISORS EIN 36-4268991 NONE | Investment advisory (plan) Service code 27 | — | $31K |
| EMPLOYEE RESOURCE SYSTEMS, INC. EIN 36-3867645 NONE | Other services Service code 49 | — | $28K |
| THE NORTHERN TRUST COMPANY EIN 36-1561860 NONE | Custodial (other than securities) Service code 18 | — | $24K |
| CHANGE HEALTHCARE SOLUTIONS EIN 20-5716594 NONE | Other services Service code 49 | — | $24K |
| DOWD, BLOCH, BENNETT & CERVONE EIN 36-3371377 NONE | Legal Service code 29 | — | $23K |
| OGLETREE, DEAKINS, NASH, SMOAK EIN 57-1044820 NONE | Legal Service code 29 | — | $18K |
| LANER MUCHIN, LTD. EIN 36-3088463 NONE | Legal Service code 29 | — | $18K |
| FAIR HEALTH, INC. EIN 90-0524293 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.); Other services Service code 15 | — | $15K |
| DENTAL NETWORK OF AMERICA EIN 36-3339483 NONE | Claims processing; Other services Service code 12 | — | $14K |
| SOMMERS & FAHRENBACH EIN 36-1796440 NONE | Copying and duplicating Service code 36 | — | $14K |
| SEGAL SELECT INSURANCE SERVICES EIN 46-0619194 NONE | Insurance agents and brokers Service code 22 | — | $10K |
| BMO HARRIS BANK NA EIN 36-2085229 NONE | Other fees; Investment management fees paid indirectly by plan; Investment management fees paid directly by plan; Investment management; Custodial (securities) Service code 19 | — | $8K |
| PREFERRED NETWORK ACCESS, INC. EIN 36-4018433 NONE | Other services Service code 49 | — | $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 | 1,500 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 860 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 2,360 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,490 | $89K |
| Stop-loss / reinsurancereinsurance | THE UNION LABOR LIFE INSURANCE COMPANY | 1,663 | $931K |
| Other | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,490 | $89K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,663 | — |
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 comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.