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 |
|---|---|---|---|
| CERNER HEALTH CONNECTIONS INC. EIN 43-1732404 NONE | Contract Administrator Service code 13 | — | $2.0M |
| BLUE CROSS BLUE SHIELD OF IL EIN 36-1236610 NONE | Other insurance fees and expenses; Contract Administrator; Claims processing Service code 12 | — | $1.8M |
| UNION EYES, LLC EIN 83-3067276 NONE | Contract Administrator Service code 13 | — | $845K |
| EXPRESS SCRIPTS, INC. EIN 43-1420563 NONE | Contract Administrator; Claims processing Service code 12 | — | $763K |
| NATIONAL INVST SVCS OF AMERICA LLC EIN 84-3937993 NONE | Investment management fees paid directly by plan; Investment management Service code 28 | — | $293K |
| PREFERRED NETWORK ACCESS, INC. EIN 36-4018433 NONE | Other services Service code 49 | — | $252K |
| THE SEGAL COMPANY (MIDWEST), INC. EIN 13-1975125 NONE | Actuarial; Consulting (general) Service code 11 | — | $229K |
| LEGACY PROFESSIONALS LLP EIN 32-0043599 NONE | Accounting (including auditing) Service code 10 | — | $207K |
| GREGORIO, STEC, KLEIN & HOSE EIN 36-4028033 NONE | Legal Service code 29 | — | $171K |
| ZELIS PAYMENTS HOLDING LLC EIN 84-3069529 NONE | Other fees; Other services Service code 49 | — | $153K |
| HINES AND ASSOCIATES, INC. EIN 36-3545085 NONE | Other services Service code 49 | — | $149K |
| BRIDGEWAY BENEFIT TECHNOLOGIES LLC EIN 52-1796473 NONE | Consulting (general); Recordkeeping fees; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $119K |
| JOSEPH OHM EIN 36-4026252 EMPLOYEE | Plan Administrator; Employee (plan) Service code 14 | — | $113K |
| OPTUM FINANCIAL, INC. EIN 47-0858530 NONE | Contract Administrator Service code 13 | — | $107K |
| DELTA DENTAL OF ILLINOIS EIN 36-2612058 NONE | Claims processing; Contract Administrator Service code 12 | — | $82K |
| ANTHONY ROTTMAN EIN 36-4026252 EMPLOYEE | Employee (plan) Service code 30 | — | $82K |
| GRACIELA DELGADO EIN 36-4026252 EMPLOYEE | Employee (plan) Service code 30 | — | $80K |
| LANER MUCHIN, LTD. EIN 36-3088463 NONE | Legal Service code 29 | — | $75K |
| LISA SURDYK EIN 36-4026252 EMPLOYEE | Employee (plan) Service code 30 | — | $66K |
| MARIDZA TORRES-RAMOS EIN 36-4026252 EMPLOYEE | Employee (plan) Service code 30 | — | $63K |
| WASHINGTON CAPITAL MANAGEMENT, INC. EIN 91-1042342 NONE | Investment management fees paid directly by plan; Investment management Service code 28 | — | $61K |
| EMPLOYEE RESOURCE SYSTEMS, INC. EIN 36-3867645 NONE | Other services Service code 49 | — | $59K |
| LISA BOWE EIN 36-4026252 EMPLOYEE | Employee (plan) Service code 30 | — | $54K |
| JENNIFER KREJCA EIN 36-4026252 EMPLOYEE | Employee (plan) Service code 30 | — | $47K |
| NANCY JONES EIN 36-4026252 EMPLOYEE | Employee (plan) Service code 30 | — | $46K |
| ELIZABETH STIERLE EIN 36-4026252 EMPLOYEE | Employee (plan) Service code 30 | — | $45K |
| MAIRE O'BRIEN EIN 36-4026252 EMPLOYEE | Employee (plan) Service code 30 | — | $36K |
| HERTZ CONSULTING LLC NONE | Other services Service code 49 | 5000 S 5TH AVE HINES, IL 60141 | $33K |
| DATAMATION IMAGING SERVICES CORP. EIN 36-4303011 NONE | Other services Service code 49 | — | $29K |
| PAUL BOUDREAU EIN 36-4026252 EMPLOYEE | Employee (plan) Service code 30 | — | $27K |
| CHRISTINE STRONG EIN 36-4026252 EMPLOYEE | Employee (plan) Service code 30 | — | $26K |
| EYEMED VISION CARE, LLC EIN 31-1656473 NONE | Contract Administrator; Claims processing Service code 12 | — | $20K |
| STRATEGIC CAPITAL INV. ADVISORS EIN 36-4268991 NONE | Investment advisory (plan) Service code 27 | — | $20K |
| AMALGAMATED BANK OF CHICAGO EIN 36-0721895 NONE | Investment management fees paid indirectly by plan; Custodial (securities); Float revenue Service code 19 | — | $15K |
| MORGAN BIRGE AND ASSOCIATES, INC. EIN 36-4330980 NONE | Other services; Other fees Service code 49 | — | $12K |
| STADTLER TECHNOLOGIES EIN 46-2406523 NONE | Other services Service code 49 | — | $10K |
| BMO HARRIS, NA EIN 36-2085229 NONE | Investment management fees paid indirectly by plan Service code 52 | — | $9K |
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 | 3,624 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 3,624 | 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.