No brokers reported on this filing.
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ALLIED BENEFIT SYSTEMS EIN 36-3086057 TPA | Contract Administrator Service code 13 | 200 WEST ADAMS ST. STE 300 CHICAGO, IL 60606 | $87K |
| BLUE CROSS BLUE SHIELD PPO | Contract Administrator Service code 13 | PO BOX 1186 CHICAGO, IL 60690 | $44K |
| DONNE INSURANCE GROUP EIN 36-2226556 BROKER | Insurance agents and brokers Service code 22 | 7777 W 159TH STREET SUITE B TINLEY PARK, IL 60477 | $36K |
| AMERICAN HEALTH HOLDING EIN 31-1368946 UTILIZATION REVIEW | Consulting fees Service code 70 | 7400 WEST CAMPUS ROAD F-510 NEW ALBANY, OH 43054 | $6K |
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 | 330 | 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) | 330 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | RELIASTAR LIFE INSURANCE COMPANY | 779 | $179K |
| Short-term disability | RELIASTAR LIFE INSURANCE COMPANY | 779 | $179K |
| Long-term disability | RELIASTAR LIFE INSURANCE COMPANY | 779 | $179K |
| Stop-loss / reinsurancereinsurance | QBE INSURANCE CORPORATION | 295 | $397K |
| Other | RELIASTAR LIFE INSURANCE COMPANY | 779 | $179K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 779 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.
Filing reports zero broker compensation on a plan over 100 participants. Likely direct-write or unreported — worth a knock.
Multiple-employer welfare arrangement. Specific regulatory and compliance context; specific consultant niche.