| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| VISION SERVICE PLAN3 | P.O. BOX 997100 SACRAMENTO, CA 958999989 | VISION SERVICE PLAN | — | $69K | $69K | 14.49% |
| RICHARD TARSITANO3 | 15660 MIDWEST ROAD SUITE 230 OAKBROOK TERRACE, IL 60181 | UNUM LIFE INSURANCE CO OF AMERICA | $761 | $38 | $799 | 15.74% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| PROFESSIONAL BENEFIT ADMINISTRATORS EIN 36-3384135 NONE | Claims processing Service code 12 | — | $693K |
| MEDICAL COST MANAGEMENT CORP EIN 36-3445315 NONE | Other services Service code 49 | — | $481K |
| FRANCZEK RADELET P.C. EIN 36-3924177 NONE | Legal Service code 29 | — | $337K |
| JOHNSON & KROL, LLC EIN 36-4342024 NONE | Legal Service code 29 | — | $217K |
| NATIONAL INVESTMENT SERVICES, INC EIN 80-0169636 NONE | Investment management fees paid directly by plan; Investment management Service code 28 | — | $184K |
| CONDUENT HR CONSULTING, LLC NONE | Actuarial Service code 11 | 17000 FEDERAL DRIVE ALLEN PARK, MI 48101 | $162K |
| EXPRESS SCRIPTS EIN 43-1420563 NONE | Claims processing Service code 12 | — | $156K |
| STEVE BUKOVAC EIN 36-2331071 PLAN ADMINISTRATOR | Plan Administrator Service code 14 | — | $139K |
| DELTA DENTAL OF ILLINOIS EIN 36-2612058 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $129K |
| METROPOLITAN WEST ASSET MANAGEMENT NONE | Investment management; Investment management fees paid directly by plan; Investment management fees paid indirectly by plan Service code 28 | 865 SOUTH FIGUEROA STREET LOS ANGELES, CA 90017 | $127K |
| TERRY MANLEY EIN 36-2331071 EMPLOYEE | Employee (plan) Service code 30 | — | $101K |
| PART D ADVISORS, INC NONE | Actuarial Service code 11 | — | $100K |
| TELEDOC EIN 04-3705970 NONE | Other services Service code 49 | — | $91K |
| INNOVATIVE SOFTWARE SOLUTIONS, INC EIN 23-2182079 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $88K |
| MACNELL ACCOUNTING AND CONSULTING L EIN 30-0510353 NONE | Accounting (including auditing) Service code 10 | — | $86K |
| BONNIE KOLL EIN 36-2331071 EMPLOYEE | Employee (plan) Service code 30 | — | $79K |
| JEANINE EARTH-GILLUND EIN 36-2331071 ASST PLAN ADMINISTRATOR | Plan Administrator Service code 14 | — | $79K |
| FIRST MIDWEST BANK WEALTH MGMT EIN 36-6064763 NONE | Custodial (securities) Service code 19 | — | $71K |
| VALERIE ANDERSON EIN 36-2331071 EMPLOYEE | Employee (plan) Service code 30 | — | $66K |
| KRISTINE BENDY EIN 36-2331071 EMPLOYEE | Employee (plan) Service code 30 | — | $48K |
| CAROL GRIMMETT EIN 36-2331071 EMPLOYEE | Employee (plan) Service code 30 | — | $48K |
| CALIBRE CPA GROUP PLLC EIN 47-0900880 NONE | Accounting (including auditing) Service code 10 | 19615 S. LAGRANGE ROAD MOKENA, IL 60448 | $46K |
| MARY MCGRATH EIN 36-2331071 EMPLOYEE | Employee (plan) Service code 30 | — | $42K |
| LISA CONNER EIN 36-2331071 EMPLOYEE | Employee (plan) Service code 30 | — | $38K |
| NICOLE KERKSTRA EIN 36-2331071 EMPLOYEE | Employee (plan) Service code 30 | — | $34K |
| TINA SWANSON EIN 36-2331071 EMPLOYEE | Employee (plan) Service code 30 | — | $31K |
| TOWERS WATSON EIN 26-0775680 NONE | Contract Administrator Service code 13 | — | $29K |
| JANET NEWMAN EIN 36-2331071 EMPLOYEE | Employee (plan) Service code 30 | — | $29K |
| VICTORIA ROJAS EIN 36-2331071 EMPLOYEE | Employee (plan) Service code 30 | — | $27K |
| INTERACTIVE HEALTH, INC EIN 36-3798756 NONE | Other services Service code 49 | — | $26K |
| STRATEGIC CAPITAL INVEST ADVISORS EIN 36-4268991 NONE | Consulting (general) Service code 16 | — | $25K |
| K-PLUS TECHNOLOGY SOLUTIONS EIN 36-4282001 NONE | Accounting (including auditing) Service code 10 | — | $14K |
| TRILOGY CONSULTING GROUP INC NONE | Consulting (general) Service code 16 | 2021 MIDWEST ROAD OAK BROOK, IL 60523 | $14K |
| MIDWEST EMPLOYEE BENEFIT FUNDS COAL NONE | Other services Service code 49 | 6170 JOLIET ROAD SUITE 2 COUNTRYSIDE, IL 60525 | $10K |
| KLEAN-KO INC EIN 36-2780462 NONE | Other services Service code 49 | — | $9K |
| OPTUMRX PBM (CATAMARAN) EIN 11-2581812 NONE | Claims processing Service code 12 | — | $7K |
| THE DANIEL & HENRY CO EIN 43-0634945 NONE | Insurance agents and brokers Service code 22 | — | $0 |
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 | 5,716 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 849 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 6,565 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | VISION SERVICE PLAN | 5,545 | $475K |
| Life insurance | DEARBORN NATIONAL LIFE INSURANCE COMPANY | 26 | $7K |
| Long-term disability | UNUM LIFE INSURANCE CO OF AMERICA | 10 | $5K |
| Other | DEARBORN NATIONAL LIFE INSURANCE COMPANY | 26 | $7K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 5,545 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.