| 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 | $428 | — | $428 | 12.01% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| OPTUMRX, INC. EIN 33-0441200 NONE | Direct payment from the plan; Float revenue; Other fees; Claims processing Service code 12 | — | $87K |
| LOYOLA UNIVERSITY MED CT EIN 36-4015560 NONE | Direct payment from the plan Service code 50 | — | $38K |
| UMR, INC. EIN 39-1995276 NONE | Claims processing Service code 12 | — | $34K |
| OSF LITTLE COMPANY OF MARY MED EIN 37-0813229 NONE | Direct payment from the plan Service code 50 | — | $16K |
| NORTHWESTERN MEM HOSP EIN 37-0960170 NONE | Direct payment from the plan Service code 50 | — | $14K |
| LABORATORY CORPORATION OF AMER EIN 13-3757370 NONE | Direct payment from the plan Service code 50 | — | $12K |
| HOLY CROSS HOSPITAL EIN 36-2170133 NONE | Direct payment from the plan Service code 50 | — | $9K |
| DUPAGE MEDICAL GROUP LTD EIN 36-2657618 NONE | Direct payment from the plan Service code 50 | — | $6K |
| MACNEAL HOSPITAL EIN 36-3332852 NONE | Direct payment from the plan Service code 50 | — | $6K |
| LOYOLA UNIV MED CTR EIN 36-4015560 NONE | Direct payment from the plan Service code 50 | — | $6K |
| INGALLS MEMORIAL HOSPITAL EIN 36-2170866 NONE | Direct payment from the plan Service code 50 | — | $6K |
| CARDIOTHORACIC VASCULAR SURG EIN 36-3807853 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 | 82 | 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) | 82 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 82 | $4K |
| Stop-loss / reinsurancereinsurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 84 | $391K |
| Other | SUN LIFE ASSURANCE COMPANY OF CANADA | 82 | $4K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 84 | — |
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.