| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ASSUREDPARTNERS3 Filed as: ASSURED PARTNERS NL LLC | 4500 TOWN CENTER BLVD, SUITE 200 JEFFERSONVILLE, IN 47130 | UNICARE LIFE & HEALTH INSURANCE COMPANY | — | $663 | $663 | 0.91% |
| AMERICAN WESTBROOK INS SERVICES LLC3 Filed as: AMERICAN WESTBROOK INS SERVICES INC | 4 WESTBROOK CORP CENTER STE 500 WESTCHESTER, IL 60154 | UNICARE LIFE & HEALTH INSURANCE COMPANY | $540 | — | $540 | 0.74% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UNION MEDICAL CENTER, INC. EIN 36-2430606 NONE | Contract Administrator; Claims processing Service code 12 | — | $2.8M |
| OPTUM RX, INC. EIN 33-0441200 NONE | Float revenue; Direct payment from the plan; Other fees; Contract Administrator; Claims processing Service code 12 | — | $932K |
| SPECIALITY CARE MANAGEMENT, LLC EIN 20-5787836 NONE | Other services Service code 49 | — | $447K |
| HEALTHLINK, INC. EIN 43-1364135 NONE | Other fees; Other services; Other commissions Service code 49 | — | $172K |
| HINES & ASSOCIATES EIN 36-3545085 NONE | Other services Service code 49 | — | $169K |
| LEGACY PROFESSIONALS LLP EIN 32-0043599 NONE | Accounting (including auditing) Service code 10 | — | $140K |
| HEALTH PLAN SYSTEMS, INC. EIN 01-0589640 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.); Other services Service code 15 | — | $116K |
| K. RANDLE EIN 36-2418276 EMPLOYEE | Employee (plan) Service code 30 | — | $72K |
| CERIS EIN 95-3382819 NONE | Other services Service code 49 | — | $51K |
| J. MACK EIN 36-2418276 EMPLOYEE | Employee (plan) Service code 30 | — | $50K |
| PREFERRED NETWORK ACCESS, INC EIN 36-4018433 NONE | Other services Service code 49 | — | $48K |
| ASHER, GITTLER, & D'ALBA, LTD. EIN 36-2786883 NONE | Legal Service code 29 | — | $48K |
| G. RED EIN 36-2418276 EMPLOYEE | Employee (plan) Service code 30 | — | $47K |
| E. COSTA EIN 36-2418276 EMPLOYEE | Employee (plan) Service code 30 | — | $43K |
| L. RODRIGUEZ EIN 36-2418276 EMPLOYEE | Employee (plan) Service code 30 | — | $41K |
| C. BARNETT EIN 36-2418276 EMPLOYEE | Employee (plan) Service code 30 | — | $41K |
| E. BROWN EIN 36-2418276 EMPLOYEE | Employee (plan) Service code 30 | — | $37K |
| S. ORTIZ EIN 36-2418276 EMPLOYEE | Employee (plan) Service code 30 | — | $37K |
| G. RIPPY EIN 36-2418276 EMPLOYEE | Employee (plan) Service code 30 | — | $36K |
| R. WHITAKER EIN 36-2418276 EMPLOYEE | Employee (plan) Service code 30 | — | $36K |
| J. JONES EIN 36-2418276 EMPLOYEE | Employee (plan) Service code 30 | — | $35K |
| C. HARRIS EIN 36-2418276 EMPLOYEE | Employee (plan) Service code 30 | — | $32K |
| R. WEAVER EIN 36-2418276 EMPLOYEE | Employee (plan) Service code 30 | — | $32K |
| THE HENSLEY CO. EIN 36-1210990 NONE | Other services Service code 49 | — | $31K |
| SOMMERS & FAHRENBACH, INC. EIN 36-1796440 NONE | Participant communication; Copying and duplicating Service code 36 | — | $31K |
| BANSLEY AND KIENER LLP EIN 36-2152389 NONE | Accounting (including auditing) Service code 10 | — | $30K |
| C. SHELBY EIN 36-2418276 EMPLOYEE | Employee (plan) Service code 30 | — | $26K |
| THE SEGAL COMPANY (MIDWEST), INC. EIN 13-1975125 NONE | Actuarial; Consulting (general) Service code 11 | — | $24K |
| ABSOLUTE SOLUTIONS LLC EIN 27-3584158 NONE | Other services Service code 49 | — | $21K |
| COMERICA BANK EIN 42-1741646 NONE | Shareholder servicing fees; Custodial (securities); Other investment fees and expenses; Other services; Float revenue Service code 19 | — | $17K |
| APPLEGATE CONSULTING GROUP EIN 45-4769589 NONE | Consulting (general) Service code 16 | — | $11K |
| K-PLUS COMPUTER SERVICES, LLC EIN 36-4282001 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $11K |
| BASYS LLC EIN 52-1796473 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.); Other services Service code 15 | — | $10K |
| PSG CONSULTING LLC EIN 27-2345574 NONE | Consulting (general) Service code 16 | — | $10K |
| MANAGED CARE STAFFERS EIN 36-4411050 NONE | Other services Service code 49 | — | $9K |
| MNJ TECHNOLOGIES EIN 01-0560518 NONE | Other services Service code 49 | — | $8K |
| TAB SERVICE COMPANY EIN 36-2463139 NONE | Copying and duplicating Service code 36 | — | $7K |
| DOWD, BLOCH, BENNETT, CERVONE, AUER EIN 36-3371377 NONE | Legal Service code 29 | — | $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 | 3,706 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 3,706 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | UNICARE LIFE & HEALTH INSURANCE COMPANY | 3,641 | $73K |
| Other | UNICARE LIFE & HEALTH INSURANCE COMPANY | 3,641 | $73K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 3,641 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.