| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| COMMERCIAL GROUP INTERMEDIARIES3 | 16 EXECUTIVE COURT, SUITE 4 SOUTH BARRINGTON, IL 60010 | AMALGAMATED LIFE INSURANCE COMPANY | $12K | — | $12K | 5.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS/BLUE SHIELD EIN 36-1236610 NONE | Claims processing Service code 12 | 300 E. RANDOLPH CHICAGO, IL 60601 | $101K |
| BENEFITS MANAGEMENT GROUP EIN 20-0188125 NONE | Plan Administrator Service code 14 | 1520 KENSINGTON, SUITE 200 OAKBROOK, IL 60523 | $95K |
| JAMES V. GALLERY & ASSOCIATE EIN 20-0188135 NONE | Consulting (general) Service code 16 | 1520 KENSINGTON, SUITE 200 OAKBROOK, IL 60523 | $60K |
| CALIBRE CPA GROUP, PLLC EIN 47-0900880 NONE | Accounting (including auditing) Service code 10 | 7501 WISCONSIN AVENUE, SUITE 1200 W BETHESDA, MD 20814 | $21K |
| ASB CAPITAL MANAGEMENT LLC EIN 80-0618452 NONE | Investment management Service code 28 | 7501 WISCONSIN AVENUE, SUITE 1500 W BETHESDA, MD 20814 | $16K |
| HEALTH MANAGEMENT CONCEPTS, INC. EIN 75-3189468 NONE | Direct payment from the plan; Other services Service code 49 | 32 HAMPDEN STREET SPRINGFIELD, MA 01103 | $10K |
| GREGORIO & ASSOCIATES EIN 36-4028033 NONE | Legal Service code 29 | 2 N LASALLE ST. SUITE 1650 CHICAGO, IL 60602 | $9K |
| SAV-RX EIN 47-0527013 NONE | Claims processing Service code 12 | 224 NORTH PARK AVE FREMONT, NE 68025 | $7K |
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 | 162 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 162 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | AMALGAMATED LIFE INSURANCE COMPANY | 162 | $33K |
| Stop-loss / reinsurancereinsurance | AMALGAMATED LIFE INSURANCE COMPANY | 162 | $242K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 162 | — |
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.