| 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 | $578 | $29 | $607 | 15.77% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| PROFESSIONAL BENEFIT ADMINISTRATORS EIN 36-3384135 NONE | Claims processing Service code 12 | — | $736K |
| MEDICAL COST MANAGEMENT CORP EIN 36-3445315 NONE | Other services Service code 49 | — | $482K |
| EPLAN LLC EIN 20-3720767 NONE | Other services Service code 49 | — | $284K |
| EXPRESS SCRIPTS EIN 43-1420563 NONE | Claims processing Service code 12 | — | $245K |
| PILLARRX CONSULTING NONE | Claims processing Service code 12 | 10400 W. INNOVATION DRIVE, STE. 105 MILWAUKEE, WI 53226 | $185K |
| NATIONAL INVESTMENT SERVICES, INC EIN 80-0169636 NONE | Investment management fees paid directly by plan; Investment management Service code 28 | — | $182K |
| JOHNSON & KROL, LLC EIN 36-4342024 NONE | Legal Service code 29 | — | $165K |
| DELTA DENTAL OF ILLINOIS EIN 36-2612058 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $134K |
| STEVE BUKOVAC EIN 36-2331071 PLAN ADMINISTRATOR | Plan Administrator Service code 14 | — | $128K |
| FRANCZEK RADELET P.C. EIN 36-3924177 NONE | Legal Service code 29 | — | $93K |
| INNOVATIVE SOFTWARE SOLUTIONS, INC EIN 23-2182079 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $93K |
| FOSTER & FOSTER INC. NONE | Actuarial; Consulting (general) Service code 11 | 184 SHUMAN BLVD., SUITE 305 NAPERVILLE, IL 60563 | $89K |
| MACNELL ACCOUNTING AND CONSULTING L EIN 30-0510353 NONE | Accounting (including auditing) Service code 10 | — | $88K |
| TELEDOC EIN 04-3705970 NONE | Other services Service code 49 | — | $85K |
| TERRY MANLEY EIN 36-2331071 EMPLOYEE | Employee (plan) Service code 30 | — | $77K |
| JEANINE EARTH-GILLUND EIN 36-2331071 ASST PLAN ADMINISTRATOR | Plan Administrator Service code 14 | — | $74K |
| CAROL GRIMMETT EIN 36-2331071 EMPLOYEE | Employee (plan) Service code 30 | — | $68K |
| HOLLY CAMPBELL EIN 36-2331071 EMPLOYEE | Employee (plan) Service code 30 | — | $60K |
| INTERACTIVE HEALTH, INC EIN 36-3798756 NONE | Other services Service code 49 | — | $53K |
| KRISTINE BENDY EIN 36-2331071 EMPLOYEE | Employee (plan) Service code 30 | — | $51K |
| CALIBRE CPA GROUP PLLC EIN 47-0900880 NONE | Accounting (including auditing) Service code 10 | 19615 S. LAGRANGE ROAD MOKENA, IL 60448 | $48K |
| CONDUENT HR CONSULTING, LLC NONE | Actuarial Service code 11 | 17000 FEDERAL DRIVE ALLEN PARK, MI 48101 | $46K |
| BONNIE KOLL EIN 36-2331071 EMPLOYEE | Employee (plan) Service code 30 | — | $42K |
| BUCK GLOBAL LLC NONE | Actuarial; Consulting (general) Service code 11 | PO BOX 207640 DALLAS, TX 753207640 | $40K |
| METROPOLITAN WEST ASSET MANAGEMENT NONE | Investment management fees paid directly by plan; Investment management; Investment management fees paid indirectly by plan Service code 28 | 865 SOUTH FIGUEROA STREET LOS ANGELES, CA 90017 | $35K |
| TOWERS WATSON EIN 26-0775680 NONE | Contract Administrator Service code 13 | — | $30K |
| LISA CONNER EIN 36-2331071 EMPLOYEE | Employee (plan) Service code 30 | — | $26K |
| STRATEGIC CAPITAL INVEST ADVISORS EIN 36-4268991 NONE | Consulting (general) Service code 16 | — | $26K |
| FIRST MIDWEST BANK WEALTH MGMT EIN 36-6064763 NONE | Custodial (securities) Service code 19 | — | $22K |
| MIDWEST EMPLOYEE BENEFIT FUNDS COAL NONE | Other services Service code 49 | 6170 JOLIET ROAD SUITE 2 COUNTRYSIDE, IL 60525 | $20K |
| CHEMICAL PERSONNEL SEARCH NONE | Other services Service code 49 | 1 WESTBROOK CORPORATE CENTER WESTCHESTER, IL 60154 | $15K |
| K-PLUS TECHNOLOGY SOLUTIONS EIN 36-4282001 NONE | Accounting (including auditing) Service code 10 | — | $14K |
| MARSH & MCLENNAN AGENCY LLC NONE | Consulting (general) Service code 16 | PO BOX 848315 DALLAS, TX 75284 | $10K |
| KLEAN-KO INC EIN 36-2780462 NONE | Other services Service code 49 | — | $9K |
| STROKE DETECT PLUS NONE | Other services Service code 49 | 2407 SW 9TH STREET DES MOINES, IA 50315 | $8K |
| 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 | 5,756 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 882 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 6,638 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | VISION SERVICE PLAN | 5,606 | $474K |
| Life insurance | DEARBORN NATIONAL LIFE INSURANCE COMPANY | 24 | $7K |
| Long-term disability | UNUM LIFE INSURANCE CO OF AMERICA | 9 | $4K |
| Other | DEARBORN NATIONAL LIFE INSURANCE COMPANY | 24 | $7K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 5,905 | — |
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.