| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| VISION SERVICE PLAN3 | P.O. BOX 997100 SACRAMENTO, CA 958999989 | VISION SERVICE PLAN | — | $87K | $87K | 15.30% |
| RICHARD TARSITANO3 | 15660 MIDWEST ROAD, STE 230 OAKBROOK TERRACE, IL 60181 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $846 | $42 | $888 | 15.74% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF IL EIN 36-1236610 NONE | Contract Administrator Service code 13 | — | $2.8M |
| BENEFITS MANAGEMENT GROUP, INC. EIN 20-0188125 NONE | Claims processing Service code 12 | — | $830K |
| MEDICAL COST MANAGEMENT CORP EIN 36-3445315 NONE | Other services Service code 49 | — | $407K |
| FRANCZEK RADELET PC EIN 36-3924177 NONE | Legal Service code 29 | — | $357K |
| NATIONAL INVESTMENT SERVICES INC EIN 80-0169636 NONE | Investment management; Investment management fees paid directly by plan Service code 28 | — | $215K |
| DELTA DENTAL OF IL EIN 36-2612058 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $200K |
| ISSI EIN 23-2182079 NONE | Claims processing Service code 12 | — | $180K |
| JOHNSON & KROL, LLC EIN 36-4342024 NONE | Legal Service code 29 | — | $156K |
| XEROX CORP (BUCK CONSULT) EIN 16-0468020 NONE | Actuarial Service code 11 | — | $150K |
| METROPOLITAN WEST ASSET MANAGEMENT EIN 95-2642764 NONE | Investment management fees paid directly by plan; Investment management; Investment management fees paid indirectly by plan Service code 28 | — | $146K |
| STEVE BUKOVAC EIN 36-2331071 EMPLOYEE | Plan Administrator Service code 14 | — | $130K |
| TERRY MANLEY EIN 36-2331071 EMPLOYEE | Employee (plan) Service code 30 | — | $101K |
| MACNELL ACCOUNTING & CONSULTING LLP EIN 30-0510353 NONE | Accounting (including auditing) Service code 10 | — | $96K |
| MARY MCGRATH EIN 36-2331071 EMPLOYEE | Employee (plan) Service code 30 | — | $88K |
| BONNIE KOLL EIN 36-2331071 EMPLOYEE | Employee (plan) Service code 30 | — | $82K |
| VICTORIA ROJAS EIN 36-2331071 EMPLOYEE | Employee (plan) Service code 30 | — | $80K |
| LOIS DOPORCYK EIN 36-2331071 EMPLOYEE | Employee (plan) Service code 30 | — | $79K |
| JEANINE EARTH EIN 36-2331071 EMPLOYEE | Employee (plan) Service code 30 | — | $73K |
| LEGACY PROFESSIONALS LLP EIN 32-0043599 NONE | Accounting (including auditing) Service code 10 | — | $72K |
| OPPTUMRX PBM (CATAMARAN) EIN 11-2581812 NONE | Claims processing Service code 12 | — | $68K |
| VALERIE ANDERSON EIN 36-2331071 EMPLOYEE | Employee (plan) Service code 30 | — | $68K |
| JANET NEWMAN EIN 36-2331071 EMPLOYEE | Employee (plan) Service code 30 | — | $65K |
| ANITA PATTERSON EIN 36-2331071 EMPLOYEE | Employee (plan) Service code 30 | — | $58K |
| RIDER DICKERSON, INC EIN 36-2329183 NONE | Copying and duplicating Service code 36 | — | $50K |
| CAROL GRIMMETT EIN 36-2331071 EMPLOYEE | Employee (plan) Service code 30 | — | $49K |
| FIRST MIDWEST BANK WEALTH MGMT EIN 36-6064763 NONE | Investment management fees paid directly by plan; Custodial (securities) Service code 19 | — | $41K |
| DATAMATION IMAGING SERVICES EIN 36-4303011 NONE | Other services Service code 49 | — | $39K |
| DANIEL BILONIC EIN 36-2331071 EMPLOYEE | Employee (plan) Service code 30 | — | $34K |
| THE DANIEL AND HENRY CO. EIN 43-0634945 NONE | Insurance brokerage commissions and fees; Insurance services Service code 23 | — | $32K |
| LISA CONNER EIN 36-2331071 EMPLOYEE | Employee (plan) Service code 30 | — | $31K |
| NICOLE KERKSTRA EIN 36-2331071 EMPLOYEE | Employee (plan) Service code 30 | — | $30K |
| TINA SWANSON EIN 36-2331071 EMPLOYEE | Employee (plan) Service code 30 | — | $28K |
| STRATEGIC CAPITAL INVEST ADVISORS EIN 36-4268991 NONE | Consulting (general) Service code 16 | — | $25K |
| TOWERS WATSON EIN 26-0775680 NONE | Contract Administrator Service code 13 | — | $25K |
| INTERACTIVE HEALTH INC EIN 36-3798756 NONE | Actuarial; Consulting (general) Service code 11 | — | $20K |
| K-PLUS TECHNOLOGY SOLUTIONS EIN 36-4282001 NONE | Accounting (including auditing) Service code 10 | — | $14K |
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 | 5,815 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 141 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 5,956 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | VISION SERVICE PLAN | 5,968 | $567K |
| Life insurance | DEARBORN NATIONAL LIFE INSURANCE COMPANY | 29 | $8K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 12 | $6K |
| Other | DEARBORN NATIONAL LIFE INSURANCE COMPANY | 29 | $8K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 5,968 | — |
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.