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 BLUESHIELD OF ILLINOIS EIN 36-1236610 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $474K |
| CYGAN HAYES,LTD. EIN 36-3332152 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $149K |
| THE SEGAL GROUP,INC. EIN 13-1975125 NONE | Direct payment from the plan; Actuarial Service code 11 | — | $94K |
| LUCY N GUERRERO EIN 36-2344463 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $85K |
| SANDS CAPITAL MANAGEMENT,LLC EIN 20-2830751 NONE | Investment management; Investment management fees paid directly by plan; Investment management fees paid indirectly by plan Service code 28 | — | $77K |
| BONNIE L CARUSO EIN 36-2344463 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $63K |
| TERRY A ROCCO EIN 36-2344463 PLAN ADMINISTRATOR | Direct payment from the plan; Plan Administrator Service code 14 | — | $59K |
| HARRIS ASSOCIATES L.P. EIN 04-3276558 NONE | Investment management fees paid indirectly by plan; Investment management; Investment management fees paid directly by plan Service code 28 | — | $59K |
| PAVILION ADVISORY GROUP, INC. EIN 04-3831795 NONE | Direct payment from the plan; Investment advisory (plan) Service code 27 | — | $45K |
| INNOVATIVE SOFTWARE SOLUTIONS, INC. EIN 23-2182079 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.); Direct payment from the plan Service code 15 | — | $41K |
| JOANNA PROBOLA EIN 36-2344463 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $39K |
| MICHELE A SCHULTZ EIN 36-2344463 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $39K |
| PRASAD I ELAMANA EIN 36-2344463 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $36K |
| DENISE M BOZYK EIN 36-2344463 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $29K |
| CAROL TUCKER EIN 36-2344463 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $27K |
| SILVERCREST ASSET MANAGEMENT GROUP NONE | Investment management; Investment management fees paid indirectly by plan; Investment management fees paid directly by plan Service code 28 | 1330 AVE OF AMERICAS 38FL NEW YORK, NY 10019 | $26K |
| BAUM SIGMAN AUERBACH & NEUMAN LTD. EIN 36-2744057 NONE | Direct payment from the plan; Legal Service code 29 | — | $22K |
| BMO HARRIS N.A. NONE | Investment management fees paid indirectly by plan; Custodial (securities); Investment management fees paid directly by plan; Investment management Service code 19 | P.O. BOX 755 CHICAGO, IL 60690 | $18K |
| CHUBB & SONS NONE | Direct payment from the plan; Insurance brokerage commissions and fees Service code 50 | 15 MOUNTAIN VIEW ROAD WARREN, NJ 07059 | $14K |
| SOMMERS & FAHRENBACH NONE | Copying and duplicating; Other services Service code 36 | 3301 W BELMONT AVE CHICAGO, IL 60618 | $11K |
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 | 1,082 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 7 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,089 | 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.