| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| UMR, INC.3 Filed as: UMR | 5151 PFEIFFER RD ML 400 PFEIFFER WOODS CINCINNATI, OH 45242 | SUN LIFE ASSURANCE COMPANY OF CANADA | — | $4K | $4K | 0.57% |
| BENEFITS CONCEPTS AND SERVICES INC3 | 8 OLD GROVE LN ALTAMONTE SPRINGS, FL 32701 | SUN LIFE ASSURANCE COMPANY OF CANADA | $488 | — | $488 | 11.06% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| FRESENIUS MEDICAL CARE NORTH EIN 46-1203188 NONE | Direct payment from the plan Service code 50 | — | $438K |
| OPTUMRX, INC. EIN 33-0441200 NONE | Claims processing; Float revenue; Direct payment from the plan; Other fees Service code 12 | — | $95K |
| THE COMMUNITY HOSPITAL EIN 35-1107009 NONE | Direct payment from the plan Service code 50 | — | $50K |
| UMR, INC. EIN 39-1995276 NONE | Claims processing Service code 12 | — | $49K |
| LITTLE COMPANY OF MARY HOSPITAL EIN 36-2246719 NONE | Direct payment from the plan Service code 50 | — | $25K |
| RUSH UNIVERSITY MEDICAL CENTER EIN 36-2174823 NONE | Direct payment from the plan Service code 50 | — | $23K |
| ADVOCATE ILLINOIS MASONIC EIN 36-3196629 NONE | Direct payment from the plan Service code 50 | — | $15K |
| METROSOUTH MEDICAL CENTER EIN 45-4082512 NONE | Direct payment from the plan Service code 50 | — | $15K |
| FRANCISCAN HEALTH CROWN POINT EIN 35-2074283 NONE | Direct payment from the plan Service code 50 | — | $13K |
| CHRIST HOSPITAL EIN 36-2169147 NONE | Direct payment from the plan Service code 50 | — | $12K |
| PALOS COMMUNITY HOSPITAL EIN 36-2169179 NONE | Direct payment from the plan Service code 50 | — | $12K |
| LUTHERAN GENERAL HOSPITAL EIN 36-2169147 NONE | Direct payment from the plan Service code 50 | — | $9K |
| SOUTH SUBURBAN HOSPITAL EIN 36-2169147 NONE | Direct payment from the plan Service code 50 | — | $8K |
| NORTHSHORE UNIVERSITY HEALTH SYSTEM EIN 36-3738206 NONE | Direct payment from the plan Service code 50 | — | $8K |
| SOUTHERN COOK RADIATION EIN 36-3341876 NONE | Direct payment from the plan Service code 50 | — | $7K |
| DUPAGE MEDICAL GROUP LTD EIN 36-2657618 NONE | Direct payment from the plan Service code 50 | — | $6K |
| PRESENCE SAINT JOSEPH CHICAGO EIN 36-2235165 NONE | Direct payment from the plan Service code 50 | — | $5K |
| COMMUNITY CARE NETWORK INC EIN 45-4158203 NONE | Direct payment from the plan Service code 50 | — | $5K |
| CHIRO ONE OF LAKEVIEW EIN 27-2207793 NONE | Direct payment from the plan Service code 50 | — | $5K |
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 | 119 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 119 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 121 | $4K |
| Stop-loss / reinsurancereinsurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 119 | $642K |
| Other | SUN LIFE ASSURANCE COMPANY OF CANADA | 121 | $4K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 121 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.