No insurance carriers on this filing. Self-funded welfare plans typically pay TPAs and PBMs through Schedule C, not Schedule A.
No brokers reported on this filing.
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF IL EIN 36-1236610 NONE | Claims processing; Other insurance fees and expenses; Contract Administrator Service code 12 | — | $1.7M |
| NATIONAL INVESTMENT SERVICES, INC. EIN 80-0169636 NONE | Investment management fees paid directly by plan; Investment management Service code 28 | — | $303K |
| HINES AND ASSOCIATES, INC. EIN 36-3545085 NONE | Other services Service code 49 | — | $267K |
| GREGORIO MARCO EIN 36-4028033 NONE | Legal Service code 29 | — | $262K |
| LEGACY PROFESSIONALS LLP EIN 32-0043599 NONE | Accounting (including auditing) Service code 10 | — | $204K |
| TOTAL ADMIN SERVICES CORPORATION EIN 36-1561025 NONE | Contract Administrator Service code 13 | — | $157K |
| PREFERRED NETWORK ACCESS, INC. EIN 36-4018433 NONE | Other services Service code 49 | — | $152K |
| LANER MUCHIN LTD. EIN 36-3088463 NONE | Legal Service code 29 | — | $133K |
| ANTHONY ROTTMAN EIN 32-2141153 EMPLOYEE | Employee (plan) Service code 30 | — | $127K |
| BICC EIN 55-0672859 NONE | Other services; Recordkeeping and information management (computing, tabulating, data processing, etc.); Consulting (general) Service code 15 | — | $105K |
| DELTA DENTAL OF ILLINOIS EIN 36-2612058 NONE | Claims processing; Contract Administrator Service code 12 | — | $90K |
| JOSEPH OHM EIN 32-2141153 EMPLOYEE | Employee (plan); Plan Administrator Service code 14 | — | $81K |
| CONDUENT INC. EIN 81-2983623 NONE | Consulting (general); Actuarial Service code 11 | — | $80K |
| IGNAZIA SURDYK EIN 32-2141153 EMPLOYEE | Employee (plan) Service code 30 | — | $72K |
| CHRIS KOGUT EIN 32-2141153 EMPLOYEE | Employee (plan) Service code 30 | — | $69K |
| ANGELA SMOLINSKI EIN 32-2141153 EMPLOYEE | Employee (plan) Service code 30 | — | $67K |
| DATAMATION IMAGING SERVICES EIN 36-4303011 NONE | Other services Service code 49 | — | $63K |
| SUZANNE MORRIN EIN 32-2141153 EMPLOYEE | Employee (plan) Service code 30 | — | $62K |
| GRACIELA DELGADO EIN 32-2141153 EMPLOYEE | Employee (plan) Service code 30 | — | $60K |
| ANNETTE KEYS EIN 32-2141153 EMPLOYEE | Employee (plan) Service code 30 | — | $60K |
| EXPRESS SCRIPTS, INC. EIN 43-1420563 NONE | Claims processing; Contract Administrator Service code 12 | — | $57K |
| NANCY JONES EIN 32-2141153 EMPLOYEE | Employee (plan) Service code 30 | — | $56K |
| JENNIFER KRECJA EIN 32-2141153 EMPLOYEE | Employee (plan) Service code 30 | — | $54K |
| DR. NADIM KHOURY NONE | Other services Service code 49 | 676 N. SAINT CLAIR CHICAGO, IL 60611 | $54K |
| ELIZABETH STIERLE EIN 32-2141153 EMPLOYEE | Employee (plan) Service code 30 | — | $52K |
| EMPLOYEE RESOURCE SYSTEMS, INC. EIN 36-3867645 NONE | Other services Service code 49 | — | $52K |
| SEGAL CONSULTING EIN 13-1975125 NONE | Consulting (general); Actuarial Service code 11 | — | $46K |
| FAEGRE BAKER DANIELS LLP EIN 41-0244008 NONE | Legal Service code 29 | — | $35K |
| PAUL BOUDREAU EIN 36-0901490 EMPLOYEE | Employee (plan) Service code 30 | — | $30K |
| AMALGAMATED BANK OF CHICAGO EIN 36-0721895 NONE | Float revenue; Investment management fees paid indirectly by plan; Custodial (securities) Service code 19 | — | $25K |
| EYEMED VISION CARE LLC EIN 31-1656473 NONE | Claims processing; Contract Administrator Service code 12 | — | $22K |
| STRATEGIC CAPITAL INV. ADVISORS EIN 36-4268991 NONE | Investment advisory (plan) Service code 27 | — | $20K |
| PSG CONSULTING, LLC EIN 27-2345574 NONE | Other services Service code 49 | — | $11K |
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 | 3,539 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 3,539 | Active + retired/separated + beneficiaries. No dependents. |
No Schedule A insurance contracts on this filing — typical of fully self-funded plans, where the only headcount is the Form 5500 number above.
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."
Self-funded plan with no stop-loss carrier attached. Catastrophic-risk exposure; stop-loss specialist sales target.