No brokers reported on this filing.
| Provider | Services | Address | Compensation |
|---|---|---|---|
| SAV-RX PRESCRIPTION SERVICES EIN 86-1323040 NONE | Claims processing; Contract Administrator Service code 12 | — | $719K |
| ACTIVATE HEALTHCARE EIN 27-0908752 NONE | Other services Service code 49 | — | $451K |
| BENEFITS MANAGEMENT GROUP, INC. EIN 20-0188125 NONE | Contract Administrator; Plan Administrator Service code 13 | — | $352K |
| BLUE CROSS BLUE SHIELD OF IL EIN 36-1236610 NONE | Contract Administrator; Non-monetary compensation; Other services; Direct payment from the plan; Claims processing; Insurance brokerage commissions and fees Service code 12 | — | $284K |
| INETICO, LLC D.B.A VALENZ CARE EIN 36-4869660 NONE | Other services Service code 49 | — | $81K |
| JOHNSON & KROL LLC EIN 36-4342024 NONE | Legal Service code 29 | — | $74K |
| KROGER PRESCRIPTION PLANS EIN 20-5927634 NONE | Claims processing; Contract Administrator Service code 12 | — | $67K |
| NATL INVESTMENT SERVICES OF AMERICA EIN 84-3937993 NONE | Investment management fees paid directly by plan; Investment management Service code 28 | — | $57K |
| NYRUCK SYPHOMMARATH EIN 36-6110305 EMPLOYEE | Employee (plan) Service code 30 | — | $56K |
| TFBC, LLC EIN 27-3782504 NONE | Actuarial Service code 11 | — | $47K |
| LEGACY PROFESSIONALS LLP EIN 32-0043599 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.); Accounting (including auditing) Service code 10 | — | $39K |
| STRATEGIC CAPITAL INV. ADVISORS EIN 36-4268991 NONE | Investment advisory (plan) Service code 27 | — | $22K |
| BUCK GLOBAL, LLC EIN 83-1116912 NONE | Consulting (general) Service code 16 | — | $19K |
| U.S. BANK NATIONAL ASSOCIATION EIN 31-0841368 NONE | Investment management fees paid directly by plan; Custodial (securities); Investment management fees paid indirectly by plan Service code 19 | — | $17K |
| DELTA DENTAL OF ILLINOIS EIN 36-2612058 NONE | Claims processing; Contract Administrator Service code 12 | — | $13K |
| EMPLOYEE RESOURCE SYSTEMS EIN 36-3867645 NONE | Claims processing; Other services Service code 12 | — | $9K |
| AMALGAMATED BANK OF CHICAGO EIN 36-0721895 NONE | Float revenue; Investment management Service code 28 | — | $8K |
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 | 503 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 257 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 760 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC. | 296 | $247K |
| Life insurance | TRUSTMARK LIFE INSURANCE COMPANY | 570 | $50K |
| Other | TRUSTMARK LIFE INSURANCE COMPANY | 570 | $50K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 570 | — |
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."
Filing reports zero broker compensation on a plan over 100 participants. Likely direct-write or unreported — worth a knock.