No brokers reported on this filing.
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUECROSS BLUESHIELD OF ILLINOIS EIN 36-1236610 NONE | Direct payment from the plan; Insurance services Service code 23 | — | $82K |
| PLANTE MORAN EIN 38-1357951 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $81K |
| DELOITTE TAX LLP EIN 86-1065772 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $12K |
| BENEFITS SCRIPTS EIN 37-1454096 NONE | Direct payment from the plan; Insurance services Service code 23 | — | $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 | 0 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 134 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 134 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 88 | $56 |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 88 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.