No insurance carriers on this filing. Self-funded welfare plans typically pay TPAs and PBMs through Schedule C, not Schedule A.
No brokers reported on this filing.
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUECROSS BLUE SHIELD OF ILLINOIS EIN 36-1236610 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $473K |
| HCC LIFE INSURANCE EIN 35-1817054 NONE | Insurance services; Direct payment from the plan Service code 23 | — | $254K |
| CYGAN HAYES, LTD. EIN 36-3332152 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $199K |
| THE SEGAL COMPANY EIN 13-1975125 NONE | Direct payment from the plan; Actuarial Service code 11 | — | $162K |
| INNOVATIVE SOFTWARE SOLUTIONS, INC. EIN 23-2182079 NONE | Direct payment from the plan; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $113K |
| ACTIVE HEALTH MANAGEMENT NONE | Consulting (general); Direct payment from the plan Service code 16 | 233 SPRING STREET NEW YORK, NY 10013 | $107K |
| LUCY N. GUERRERO EIN 36-2344463 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $97K |
| EXPRESS SCRIPTS NONE | Claims processing; Direct payment from the plan Service code 12 | 1 EXPRESSWAY ST. LOUIS, MO 63121 | $78K |
| BONNIE L. CARUSO EIN 36-2344463 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $66K |
| HINES & ASSOCIATES NONE | Consulting (general); Direct payment from the plan Service code 16 | 115 E. HIGHLAND AVE 800-735-1200 ELGIN, IL 60120 | $66K |
| JOHN KALLIANIS EIN 36-2344463 PLAN ADMINISTRATOR | Direct payment from the plan; Plan Administrator Service code 14 | — | $65K |
| MARQUETTE ASSOCIATES NONE | Investment management fees paid directly by plan; Investment advisory (plan) Service code 27 | 180 N LASALLE ST 3500 CHICAGO, IL 60601 | $45K |
| BAUM SIGMAN AUERBACH & NUEMAN LTD. EIN 36-2744057 NONE | Direct payment from the plan; Legal Service code 29 | — | $43K |
| MICHELE A. SCHULTZ EIN 36-2344463 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $33K |
| VIOLA L. MUNGUIA EIN 36-2344463 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $33K |
| YVONNE NAVA EIN 36-2344463 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $32K |
| CAROL B. TUCKER EIN 36-2344463 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $29K |
| HARRIS ASSOCIATES L.P. EIN 04-3276558 NONE | Investment management fees paid directly by plan; Investment management; Investment management fees paid indirectly by plan Service code 28 | — | $29K |
| JOANNA PROBOLA EIN 36-2344463 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $28K |
| SANDS CAPITAL MANAGEMENT EIN 20-2830751 NONE | Investment management fees paid indirectly by plan; Investment management fees paid directly by plan; Investment management Service code 28 | — | $28K |
| WORLDPAY NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.); Direct payment from the plan Service code 15 | 347 RIVERSIDE AVE. JACKSONVILLE, FL 32202 | $24K |
| DELTA DENTAL OF ILLINOIS EIN 36-2612058 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $23K |
| NHIT CORE PLUS FIXED INCOME TRUST NONE | Investment management fees paid directly by plan; Direct payment from the plan Service code 50 | ONE FINANCIAL CENTER BOSTON, MA 02111 | $20K |
| ASSOCIATED AGENCIES NONE | Insurance brokerage commissions and fees; Direct payment from the plan Service code 50 | 1701 GOLF ROAD STE 3-700 ROLLING MEADOWS, IL 60008 | $18K |
| NOVENTECH NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.); Direct payment from the plan Service code 15 | 450 E. 22ND ST, STE 140 LOMBARD, IL 60148 | $15K |
| MIDWEST INTERNATIONAL TRUST COMPANY NONE | Direct payment from the plan; Investment management; Custodial (securities) Service code 19 | 5901 COLLEGE BLVD STE 100 OVERLAND PARK, KS 66211 | $14K |
| SILVERCREST ASSET MANAGEMENT GROUP NONE | Investment management fees paid indirectly by plan; Investment management fees paid directly by plan; Investment management Service code 28 | 1330 AVE OF AMERICAS 38FL NEW YORK, NY 10019 | $13K |
| GREEN LIGHT NONE | Consulting (general); Direct payment from the plan Service code 16 | 17015 N. SCOTTSDALE RD SCOTTSDALE, AZ 85255 | $10K |
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 | 1,004 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 8 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,012 | Active + retired/separated + beneficiaries. No dependents. |
No Schedule A insurance contracts on this filing — typical of fully self-funded plans, where the only headcount is the Form 5500 number above.
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."
Self-funded plan with no stop-loss carrier attached. Catastrophic-risk exposure; stop-loss specialist sales target.