| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LABOR FIRST LLC3 | 1000 MIDATLANTIC DRIVE MOUNT LAUREL, NJ 08054 | HUMANA | $6K | — | $6K | 0.81% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| EVERSIDE HEALTH/ACTIVATE/MARATHON NONE | Contract Administrator Service code 13 | 39595 W 10 MILE RD STE 101 NOVI, MI 48375 | $1.2M |
| P&P LOCAL 25 FRINGE BENEFIT FUNDS L EIN 82-2768063 NONE | Contract Administrator Service code 13 | 4600 46TH AVE ROCK ISLAND, IL 61201 | $476K |
| MIDWEST ASSOCIATION OF H&W FUNDS EIN 20-0489036 RELATED PARTY | Contract Administrator; Claims processing Service code 12 | — | $241K |
| BLUE CROSS BLUE SHIELD EIN 36-1236610 NONE | Claims processing Service code 12 | 300 E RANDOLPH ST CHICAGO, IL 60601 | $189K |
| HINES & ASSOC EIN 36-3545085 NONE | Other services Service code 49 | 115 E HIGHLAND AVE ELGIN, IL 60120 | $64K |
| BAUM SIGMAN AUERBACH & NEUMAN NONE | Legal Service code 29 | 200 W. ADAMS ST., 2000 CHICAGO, IL 60606 | $33K |
| RJ LEE AND ASSOCIATES NONE | Consulting (general) Service code 16 | 1700 52ND AVE., SUITE B MOLINE, IL 61265 | $23K |
| CALIBRE CPA GROUP PLLC EIN 47-0900880 NE | Accounting (including auditing) Service code 10 | 566 W LAKE ST STE 300 CHICAGO, IL 60661 | $20K |
| SMITH, GRAHAM & CO. EIN 76-0301817 NONE | Investment management Service code 28 | 600 TRAVIS ST 6900 HOUSTON, TX 77002 | $20K |
| VISION SERVICE PLAN EIN 20-0891619 NONE | Claims processing Service code 12 | — | $19K |
| BARTLETT & CO. LLC EIN 45-4316696 NONE | Investment management; Investment management fees paid directly by plan Service code 28 | 600 VINE ST., SUITE 2100 CINCINNATI, OH 452023896 | $14K |
| MILLIMAN EIN 91-0675641 NONE | Actuarial Service code 11 | 71 S WACKER DR CHICAGO, IL 60606 | $13K |
| HEALTH LINX NONE | Consulting (general) Service code 16 | 1404 GOODDALE BLVD COLUMBUS, OH 43212 | $12K |
| QUAD CITY BANK & TRUST NONE | Custodial (securities) Service code 19 | 3551 7TH STREET, STE 100 MOLINE, IL 61265 | $11K |
| INVESTMENT CONSULTING GROUP NONE | Investment advisory (plan) Service code 27 | 5117 JERSEY RIDGE RD., SUITE 1 DAVENPORT, IA 52807 | $10K |
| SANDS CAPITAL MANAGEMENT, LLC NONE | Investment management fees paid directly by plan; Investment management Service code 28 | 1101 WILSON BLVD., SUITE 2300 ARLINGTON, VA 22209 | $7K |
| OPTUM RX EIN 33-0441200 NONE | Claims processing; Direct payment from the plan; Float revenue; Other fees Service code 12 | — | $0 |
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 | 1,094 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 497 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 1,591 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 1,078 | $207K |
| Prescription drug | HUMANA | 387 | $681K |
| Stop-loss / reinsurancereinsurance | HCC LIFE INSURANCE COMPANY | 1,262 | $231K |
| Other(2 contracts, 2 carriers) | HUMANA | 1,078 | $704K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,262 | — |
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."
Broker comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.