| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WASHINGTON STREET INSURANCE GROUP3 | P.O. BOX 360 PALOS PARK, IL 60464 | THE UNION LABOR LIFE INSURANCE COMPANY | $83K | — | $83K | 3.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| AEGIS ADMINSTRATIVE SERVICES, INC. EIN 04-3701774 NONE | Contract Administrator Service code 13 | — | $1.4M |
| CIGNA HEALTH & LIFE INSURANCE COM EIN 59-1031071 NONE | Contract Administrator; Direct payment from the plan; Other services; Participant communication; Non-monetary compensation; Claims processing; Named fiduciary; Float revenue Service code 12 | — | $609K |
| FOX ROTHSCHILD, LLP EIN 23-1404723 NONE | Legal Service code 29 | — | $157K |
| SAV-RX PRESCRIPTION SERVICES EIN 47-0527013 NONE | Claims processing Service code 12 | — | $131K |
| NOBLE CONSULTING GROUP EIN 36-4362019 AFFILIATE OF AEGIS ADMIN | Consulting fees Service code 70 | — | $61K |
| WILLIAM EINHORN NONE | Named fiduciary Service code 31 | 6970 W. DIVERSEY AVENUE CHICAGO, IL 60707 | $48K |
| MACNELL ACCOUNTING AND CONSULTING EIN 30-0510353 NONE | Accounting (including auditing) Service code 10 | — | $29K |
| CBIZ, INC. EIN 31-1582098 NONE | Actuarial Service code 11 | — | $18K |
| RBC CAPITAL NONE | Investment management Service code 28 | 200 VESEY STREET, 9TH FLOOR NEW YORK, NY 10281 | $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 | 1,550 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 1,550 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Stop-loss / reinsurancereinsurance | THE UNION LABOR LIFE INSURANCE COMPANY | 1,575 | $2.8M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,575 | — |
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.