| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| VISION SERVICE PLAN3 | P.O. BOX 997100 SACRAMENTO, CA 958999989 | VISION SERVICE PLAN | — | $68K | $68K | 14.50% |
| GFF FINANCIAL, INC3 | THREE PARKWAY NORTH, STE 500 DEERFIELD, IL 60015 | DEARBORN NATIONAL LIFE INSURANCE COMPANY | $768 | — | $768 | 6.47% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| PROFESSIONAL BENEFIT ADMINISTRATORS EIN 36-3384135 NONE | Claims processing Service code 12 | — | $875K |
| PAYDHEALTH LLC NONE | Contract Administrator Service code 13 | 4001 MCEWEN RD STE 450 DALLAS, TX 752445020 | $718K |
| MEDICAL COST MANAGEMENT CORP EIN 36-3445315 NONE | Other services Service code 49 | — | $504K |
| EPLAN LLC EIN 20-3720767 NONE | Other services Service code 49 | — | $306K |
| NATIONAL INVESTMENT SERVICES, INC EIN 84-3937993 NONE | Investment management; Investment management fees paid directly by plan Service code 28 | — | $202K |
| EXPRESS SCRIPTS EIN 43-1420563 NONE | Claims processing Service code 12 | — | $178K |
| JOHNSON & KROL, LLC EIN 36-4342024 NONE | Legal Service code 29 | — | $172K |
| DELTA DENTAL OF ILLINOIS EIN 36-2612058 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $136K |
| STEVE BUKOVAC EIN 36-2331071 PLAN ADMINISTRATOR | Plan Administrator Service code 14 | — | $131K |
| BUCK GLOBAL LLC EIN 13-3954297 NONE | Consulting (general); Actuarial Service code 11 | — | $124K |
| EMPIRX HEALTH EIN 47-1226691 NONE | Contract Administrator Service code 13 | — | $123K |
| PILLARRX CONSULTING EIN 83-0714696 NONE | Claims processing Service code 12 | — | $118K |
| MORGAN, LEWIS & BOCKUS LLP EIN 23-0891050 NONE | Legal Service code 29 | — | $114K |
| FOSTER & FOSTER INC. EIN 59-1921114 NONE | Consulting (general); Actuarial Service code 11 | — | $95K |
| HOLLY CAMPBELL EIN 36-2331071 EMPLOYEE | Employee (plan) Service code 30 | — | $95K |
| MACNELL ACCOUNTING AND CONSULTING L EIN 30-0510353 NONE | Accounting (including auditing) Service code 10 | — | $92K |
| TELEDOC EIN 04-3705970 NONE | Other services Service code 49 | — | $88K |
| INNOVATIVE SOFTWARE SOLUTIONS, INC EIN 23-2182079 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $84K |
| JEANINE EARTH-GILLUND EIN 36-2331071 ASST PLAN ADMINISTRATOR | Plan Administrator Service code 14 | — | $81K |
| TERRY MANLEY EIN 36-2331071 EMPLOYEE | Employee (plan) Service code 30 | — | $80K |
| FIRST MIDWEST BANK WEALTH MGMT EIN 36-6064763 NONE | Custodial (securities) Service code 19 | — | $66K |
| BMI AUDIT SERVICE HOLDINGS, INC EIN 38-4091484 NONE | Accounting (including auditing) Service code 10 | — | $61K |
| CALIBRE CPA GROUP PLLC EIN 47-0900880 NONE | Accounting (including auditing) Service code 10 | — | $50K |
| CAROL GRIMMETT EIN 36-2331071 EMPLOYEE | Employee (plan) Service code 30 | — | $48K |
| KRISTINE BENDY EIN 36-2331071 EMPLOYEE | Employee (plan) Service code 30 | — | $46K |
| INTERACTIVE HEALTH, INC EIN 36-3798756 NONE | Other services Service code 49 | — | $33K |
| TOWERS WATSON EIN 26-0775680 NONE | Contract Administrator Service code 13 | — | $29K |
| HALEY ZIERMAN EIN 36-2331071 EMPLOYEE | Employee (plan) Service code 30 | — | $29K |
| LISA CONNER EIN 36-2331071 EMPLOYEE | Employee (plan) Service code 30 | — | $29K |
| STRATEGIC CAPITAL INVEST ADVISORS EIN 36-4268991 NONE | Consulting (general) Service code 16 | — | $26K |
| TINA SWANSON EIN 36-2331071 EMPLOYEE | Employee (plan) Service code 30 | — | $25K |
| ALBERTSON'S COMPANIES, INC NONE | Other services Service code 49 | PO BOX 742382 LOS ANGELES, CA 900742962 | $22K |
| MANAGED CARE STAFF EIN 36-4411050 NONE | Other services Service code 49 | — | $20K |
| PROVEN IT EIN 32-0064316 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $17K |
| MIDWEST EMPLOYEE BENEFIT FUNDS COAL NONE | Other services Service code 49 | 6170 JOLIET ROAD, SUITE 2 COUNTRYSIDE, IL 60525 | $15K |
| STROKE DETECT PLUS NONE | Other services Service code 49 | 2407 SW 9TH STREET DES MOINES, IA 50315 | $11K |
| KLEAN-KO INC EIN 36-2780462 NONE | Other services Service code 49 | — | $9K |
| DATAMATION IMAGING SERVICES CORP NONE | Other services Service code 49 | — | $7K |
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 | 5,649 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1,006 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 6,655 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | VISION SERVICE PLAN | 5,414 | $472K |
| Life insurance | DEARBORN NATIONAL LIFE INSURANCE COMPANY | 25 | $12K |
| Other | DEARBORN NATIONAL LIFE INSURANCE COMPANY | 25 | $12K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 5,908 | — |
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.