| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| VISION SERVICE PLAN3 | 3333 QUALITY DRIVE RANCHO CORDOVA, CA 95670 | VISION SERVICE PLAN | $14K | — | $14K | 12.26% |
| THE SEGAL COMPANY3 Filed as: THE SEGAL COMPANY (MIDWEST) INC. | 101 N. WACKER DR. STE 500 CHICAGO, IL 60606 | SUN LIFE ASSURANCE COMPANY OF CANADA | $8K | — | $8K | 8.98% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD EIN 36-1236610 NONE | Claims processing; Recordkeeping fees Service code 12 | — | $617K |
| TIC INTERNATIONAL CORPORATION EIN 13-2600875 NONE | Copying and duplicating; Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 13 | — | $67K |
| KOVITZ INVESTMENT GROUP EIN 91-2198169 NONE | Investment management; Investment management fees paid indirectly by plan Service code 28 | — | $65K |
| THE SEGAL COMPANY (MIDWEST), INC EIN 13-1975125 NONE | Insurance brokerage commissions and fees; Actuarial; Consulting (general) Service code 11 | — | $59K |
| ASB CAPITAL MANAGEMENT LLC EIN 27-0185492 NONE | Investment management Service code 28 | — | $45K |
| MEKETA INVESTMENT GROUP, INC EIN 04-2659023 NONE | Investment advisory (plan) Service code 27 | — | $31K |
| LEGACY PROFESSIONALS LLP EIN 32-0043599 NONE | Accounting (including auditing) Service code 10 | — | $21K |
| EMPLOYEE RESOURCE SERVICES, INC EIN 36-3867645 NONE | Claims processing Service code 12 | — | $18K |
| ASHER, GITTLER & D'ALBA EIN 36-2786883 NONE | Legal Service code 29 | — | $9K |
| UNION SERVICES AGENCY EIN 38-3297465 NONE | Insurance agents and brokers Service code 22 | — | $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 | 810 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 810 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF ILLINOIS | 808 | $18K |
| Vision | VISION SERVICE PLAN | 805 | $116K |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 842 | $90K |
| Other | SUN LIFE ASSURANCE COMPANY OF CANADA | 842 | $90K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 842 | — |
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 compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.