No brokers reported on this filing.
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF ILLINOIS EIN 36-1236610 NONE | Contract Administrator; Claims processing Service code 12 | 300 EAST RANDOLPH STREET CHICAGO, IL 60601 | $486K |
| RESOURCE GRAPHICS EIN 36-4022472 NONE | Copying and duplicating Service code 36 | 737 WEST ESTES AVENUE SCHAUMBURG, IL 60193 | $184K |
| TOWERS WATSON DELAWARE INC EIN 23-1159360 NONE | Consulting (general); Actuarial; Consulting fees Service code 11 | 901 NORTH GLEBE ROAD ARLINGTON, VA 22203 | $179K |
| MILLIMAN EIN 91-0675641 NONE | Consulting (general); Consulting fees; Actuarial Service code 11 | 80 LAMBERTON ROAD WINDSOR, CT 06095 | $166K |
| MCDONALD'S CORPORATION EIN 36-2361282 SAME | Plan Administrator Service code 14 | 2111 MCDONALD'S DRIVE OAK BROOK, IL 60523 | $51K |
| CAREMARK EIN 75-2882129 NONE | Contract Administrator; Claims processing Service code 12 | 745 ALEXANDRIA DRIVE NAPERVILLE, IL 60565 | $20K |
| COMPSYCH EIN 36-3739783 NONE | Contract Administrator; Claims processing Service code 12 | NBC TOWER-13TH FLOOR 455 NORTH CITYFRONT PLAZA DRIVE CHICAGO, IL 60611 | $18K |
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 | 11,668 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 304 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 11,972 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | SEE ATTACHED | 0 | $538K |
| Dental | SEE ATTACHED | 0 | $538K |
| Vision | SEE ATTACHED | 0 | $538K |
| Prescription drug | SEE ATTACHED | 0 | $538K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 0 | — |
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.