| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BENEFITS CONCEPTS AND SERVICES INC3 | 8 OLD GROVE LN ALTAMONTE SPRINGS, FL 32701 | SUN LIFE ASSURANCE COMPANY OF CANADA | $480 | — | $480 | 11.99% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| OPTUMRX, INC. EIN 33-0441200 NONE | Direct payment from the plan; Other fees; Float revenue; Claims processing Service code 12 | — | $141K |
| PRESENCE SAINT FRANCIS HOSPITAL EIN 36-2235165 NONE | Direct payment from the plan Service code 50 | — | $126K |
| J H STROGER HOSPITAL OF COOK CTY EIN 36-6006541 NONE | Direct payment from the plan Service code 50 | — | $119K |
| SHIRLEY RYAN ABILITYLAB EIN 36-2256036 NONE | Direct payment from the plan Service code 50 | — | $92K |
| CHRIST HOSPITAL EIN 36-2169147 NONE | Direct payment from the plan Service code 50 | — | $62K |
| UMR, INC. EIN 39-1995276 NONE | Claims processing Service code 12 | — | $50K |
| RIVERSIDE MEDICAL CENTER EIN 36-2414944 NONE | Direct payment from the plan Service code 50 | — | $36K |
| ELMHURST MEMORIAL HOSPITAL EIN 36-2167784 NONE | Direct payment from the plan Service code 50 | — | $29K |
| MACNEAL HOSPITAL EIN 36-3332852 NONE | Direct payment from the plan Service code 50 | — | $24K |
| PALOS COMMUNITY HOSPITAL EIN 36-2169179 NONE | Direct payment from the plan Service code 50 | — | $18K |
| NORWEGIAN AMERICAN HOSPITAL EIN 36-1564290 NONE | Direct payment from the plan Service code 50 | — | $17K |
| INGALLS MEMORIAL HOSPITAL EIN 36-2170866 NONE | Direct payment from the plan Service code 50 | — | $14K |
| COMMUNITY HOSPITAL, MUNSTER, IN EIN 35-1107009 NONE | Direct payment from the plan Service code 50 | — | $13K |
| ORTHOPAEDIC AND REHABILITATION CNTR EIN 36-3093710 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 | — | $12K |
| NORTH AM. PARTNERS IN ANESTHESIA EIN 45-4876995 NONE | Direct payment from the plan Service code 50 | — | $11K |
| DUPAGE MEDICAL GROUP EIN 36-2657618 NONE | Direct payment from the plan Service code 50 | — | $11K |
| FRANCISCAN HEALTH CROWN POINT EIN 35-2074283 NONE | Direct payment from the plan Service code 50 | — | $9K |
| PRESENCE SAINTS MARY AND ELIZABETH EIN 36-2235165 NONE | Direct payment from the plan Service code 50 | — | $9K |
| MEDICAL SERVICES RIC EIN 91-1999919 NONE | Direct payment from the plan Service code 50 | — | $8K |
| SWEDISH COVENANT HOSPITAL EIN 36-2179813 NONE | Direct payment from the plan Service code 50 | — | $7K |
| LITTLE COMPANY OF MARY HOSPITAL EIN 36-2246719 NONE | Direct payment from the plan Service code 50 | — | $6K |
| HOLY CROSS HOSPITAL EIN 36-2170133 NONE | Direct payment from the plan Service code 50 | — | $5K |
| LABCORP DUBLIN EIN 13-3757370 NONE | Direct payment from the plan Service code 50 | — | $5K |
| CENTRAL DUPAGE HOSPITAL EIN 36-2513909 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 | 111 | 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) | 111 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 103 | $4K |
| Stop-loss / reinsurancereinsurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 111 | $513K |
| Other | SUN LIFE ASSURANCE COMPANY OF CANADA | 103 | $4K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 111 | — |
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.