| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ASSUREDPARTNERS3 Filed as: ASSURED PARTNERS NL LLC | 435 WHITTINGTON PKWY SUITE 300 LOUISVILLE, KY 40222 | STANDARD INSURANCE COMPANY | — | $1K | $1K | 2.96% |
| AMERICAN WESTBROOK INSURANCE3 | 4350 WEAVER PKWY WARRENVILLE, IL 60555 | UNICARE LIFE & HEALTH INSURANCE COMPANY | $3K | — | $3K | 8.43% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UNION MEDICAL CENTER, INC. EIN 36-2430606 NONE | Claims processing; Contract Administrator Service code 12 | — | $2.8M |
| OPTUM RX, INC. EIN 33-0441200 PHARMACY BENEFIT MANAGEME | Claims processing; Other fees; Float revenue; Direct payment from the plan; Contract Administrator Service code 12 | — | $1.3M |
| SCM NEWCO LLC EIN 87-4610160 NONE | Other services Service code 49 | — | $412K |
| HINES & ASSOCIATES EIN 36-3545085 NONE | Other services Service code 49 | — | $166K |
| LEGACY PROFESSIONALS EIN 32-0043599 NONE | Accounting (including auditing); Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 10 | — | $149K |
| HEALTHLINK, INC. EIN 43-1364135 NONE | Other services; Other fees; Other commissions Service code 49 | — | $147K |
| K. RANDLE EIN 36-2418276 EMPLOYEE | Employee (plan) Service code 30 | — | $94K |
| BRIDGEWAY BENEFIT TECHNOLOGIES LLC EIN 52-1796473 NONE | Claims processing; Other services; Recordkeeping and information management (computing, tabulating, data processing, etc.); Other fees Service code 12 | — | $84K |
| R. WEAVER EIN 36-2418276 EMPLOYEE | Employee (plan) Service code 30 | — | $71K |
| MULTIPLAN EIN 13-3068979 NONE | Other services Service code 49 | — | $65K |
| H. KURTZ EIN 36-2418276 EMPLOYEE | Employee (plan) Service code 30 | — | $61K |
| E. COSTA EIN 36-2418276 ADMINISTRATOR | Employee (plan); Plan Administrator Service code 14 | — | $60K |
| THE SEGAL COMPANY (MIDWEST), INC. EIN 13-1975125 NONE | Actuarial; Consulting (general) Service code 11 | — | $59K |
| N. COX EIN 36-2418276 EMPLOYEE | Employee (plan) Service code 30 | — | $56K |
| A. ROBLEDO EIN 36-2418276 EMPLOYEE | Employee (plan) Service code 30 | — | $53K |
| G. LEE EIN 36-2418276 EMPLOYEE | Employee (plan) Service code 30 | — | $50K |
| ZELIS PAYMENTS HOLDINGS LLC EIN 84-3069529 NONE | Participant communication Service code 38 | — | $50K |
| E. ESQUINCA EIN 36-2418276 EMPLOYEE | Employee (plan) Service code 30 | — | $50K |
| PREFERRED NETWORK ACCESS, INC EIN 36-4018433 NONE | Other services Service code 49 | — | $50K |
| MANAGED CARE STAFFERS EIN 36-4411050 NONE | Other services Service code 49 | — | $49K |
| R. TAYLOR EIN 36-2418276 EMPLOYEE | Employee (plan) Service code 30 | — | $47K |
| C. BURNS EIN 36-2418276 EMPLOYEE | Employee (plan) Service code 30 | — | $45K |
| LHH RECRUITMENT SOLUTIONS EIN 59-3482208 NONE | Other services Service code 49 | — | $44K |
| P. WYNN EIN 36-2418276 EMPLOYEE | Employee (plan) Service code 30 | — | $43K |
| C. BARNETT EIN 36-2418276 EMPLOYEE | Employee (plan) Service code 30 | — | $42K |
| G. RANGEL EIN 36-2418276 EMPLOYEE | Employee (plan) Service code 30 | — | $41K |
| R. WHITAKER EIN 36-2418276 EMPLOYEE | Employee (plan) Service code 30 | — | $37K |
| E. BROWN EIN 36-2418276 EMPLOYEE | Employee (plan) Service code 30 | — | $35K |
| ASHER, GITTLER, & D'ALBA, LTD. EIN 36-2786883 NONE | Legal Service code 29 | — | $31K |
| J. MACK EIN 36-2418276 EMPLOYEE | Employee (plan) Service code 30 | — | $26K |
| N. MUHAMMAD EIN 36-2418276 EMPLOYEE | Employee (plan) Service code 30 | — | $26K |
| A. BATES EIN 36-2418276 EMPLOYEE | Employee (plan) Service code 30 | — | $25K |
| APPLEGATE CONSULTING GROUP EIN 45-4769589 NONE | Consulting (general) Service code 16 | — | $19K |
| K-PLUS COMPUTER SERVICES, LLC EIN 36-4282001 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $17K |
| DOWD, BLOCH, BENNETT, CERVONE, AUER EIN 36-3371377 NONE | Legal Service code 29 | — | $16K |
| MED-EXPERT INTERNATIONAL, INC. EIN 94-3360248 NONE | Other services Service code 49 | — | $13K |
| MNJ TECHNOLOGIES EIN 01-0560518 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.); Other services Service code 15 | — | $13K |
| PSG CONSULTING LLC EIN 14-2001350 NONE | Consulting (general) Service code 16 | — | $12K |
| GREEN LIGHT COST MANAGEMENT, LLC EIN 45-5248276 NONE | Other services Service code 49 | — | $11K |
| SOMMERS & FAHRENBACH, INC. EIN 36-1796440 NONE | Participant communication; Copying and duplicating Service code 36 | — | $6K |
| TAB SERVICE COMPANY EIN 36-2463139 NONE | Copying and duplicating Service code 36 | — | $6K |
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 | 3,321 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 3,321 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance(2 contracts, 2 carriers) | STANDARD INSURANCE COMPANY | 3,169 | $64K |
| Other(2 contracts, 2 carriers) | STANDARD INSURANCE COMPANY | 3,169 | $64K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 3,169 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.