| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| UMR, INC.3 | 11 SCOTT STREET, SUITE 100 WAUSAU, WI 54403 | SUN LIFE ASSURANCE COMPANY OF CANADA | $0 | $4K | $4K | 0.63% |
| BENEFITS CONCEPTS AND SERVICES INC3 | 8 OLD GROVE LN ALTAMONTE SPRINGS, FL 32701 | SUN LIFE ASSURANCE COMPANY OF CANADA | $549 | — | $549 | 13.01% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| RUSH UNIVERSITY MEDICAL CENTER EIN 36-2174823 NONE | Direct payment from the plan Service code 50 | — | $109K |
| OPTUMRX, INC. EIN 33-0441200 NONE | Float revenue; Other fees; Claims processing; Direct payment from the plan Service code 12 | — | $101K |
| SWEDISH COVENANT HOSPITAL EIN 36-2179813 NONE | Direct payment from the plan Service code 50 | — | $74K |
| UMR, INC. EIN 39-1995276 NONE | Claims processing Service code 12 | — | $70K |
| PRESENCE SAINT FRANCIS HOSPITAL EIN 36-2235165 NONE | Direct payment from the plan Service code 50 | — | $49K |
| APERION CARE INTERNATIONAL EIN 26-3342373 NONE | Direct payment from the plan Service code 50 | — | $43K |
| NORTHSHORE UNIVERSITY HEALTH SYSTEM EIN 36-2167060 NONE | Direct payment from the plan Service code 50 | — | $42K |
| ELMHURST MEMORIAL HOSPITAL EIN 36-2167784 NONE | Direct payment from the plan Service code 50 | — | $32K |
| NORTHWESTERN MEMORIAL HOSPITAL EIN 37-0960170 NONE | Direct payment from the plan Service code 50 | — | $29K |
| MACNEAL HOSPITAL EIN 62-1796152 NONE | Direct payment from the plan Service code 50 | — | $25K |
| SHIRLEY RYAN ABILITYLAB EIN 36-2256036 NONE | Direct payment from the plan Service code 50 | — | $23K |
| FRANCISCAN HEALTH DYER EIN 35-1835133 NONE | Direct payment from the plan Service code 50 | — | $21K |
| CHRIST HOSPITAL EIN 36-2169147 NONE | Direct payment from the plan Service code 50 | — | $17K |
| RIVERSIDE MEDICAL CENTER EIN 36-2414944 NONE | Direct payment from the plan Service code 50 | — | $16K |
| LUTHERAN GENERAL HOSPITAL EIN 36-2169147 NONE | Direct payment from the plan Service code 50 | — | $14K |
| LITTLE COMPANY OF MARY HOSPITAL EIN 36-2246719 NONE | Direct payment from the plan Service code 50 | — | $13K |
| METROSOUTH MEDICAL CENTER EIN 45-4082512 NONE | Direct payment from the plan Service code 50 | — | $12K |
| CENTRAL DUPAGE HOSPITAL EIN 36-2513909 NONE | Direct payment from the plan Service code 50 | — | $11K |
| FRANCISCAN HEALTH OLYMPIA FIELDS EIN 36-2167869 NONE | Direct payment from the plan Service code 50 | — | $11K |
| NORTHSHORE UNIVERSITY HEALTHSYSTEM EIN 36-3738206 NONE | Direct payment from the plan Service code 50 | — | $9K |
| ORTHOPAEDIC AND REHABILITATION CNTR EIN 36-3093710 NONE | Direct payment from the plan Service code 50 | — | $9K |
| HOLY CROSS HOSPITAL EIN 36-2170133 NONE | Direct payment from the plan Service code 50 | — | $8K |
| LABORATORY CORPORATION OF AMERICA EIN 13-3757370 NONE | Direct payment from the plan Service code 50 | — | $8K |
| FRESENIUS MEDICAL CARE NORTH EIN 46-1203188 NONE | Direct payment from the plan Service code 50 | — | $6K |
| NORTH AM. PARTNERS IN ANESTHESIA EIN 45-4876995 NONE | Direct payment from the plan Service code 50 | — | $6K |
| NORTHWESTERN MEDICAL FACULTY FOUND. EIN 36-3097297 NONE | Direct payment from the plan Service code 50 | — | $6K |
| FRANCISCAN PHYSICIAN NETWORK EIN 61-1630276 NONE | Direct payment from the plan Service code 50 | — | $5K |
| ATHLETICO LTD EIN 36-3771769 NONE | Direct payment from the plan Service code 50 | — | $5K |
| HEALTH DELIVERY MANAGEMENT EIN 36-4085751 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 | 120 | 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) | 120 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 117 | $4K |
| Stop-loss / reinsurancereinsurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 120 | $563K |
| Other | SUN LIFE ASSURANCE COMPANY OF CANADA | 117 | $4K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 120 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.