No brokers reported on this filing.
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUECROSS BLUESHIELD OF ILLINOIS EIN 36-1236610 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.); Claims processing; Contract Administrator Service code 12 | — | $447K |
| ARNOLD & KADJAN EIN 36-2498571 NONE | Legal Service code 29 | — | $172K |
| STEWART C MILLER EIN 35-1820020 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.); Contract Administrator Service code 13 | — | $46K |
| AMALGAMATED BANK EIN 36-0721895 NONE | Custodial (securities); Investment management Service code 19 | — | $38K |
| BANSLEY & KIENER, LLP EIN 36-2152389 NONE | Accounting (including auditing) Service code 10 | — | $29K |
| TFBC, LLC EIN 27-3782504 NONE | Consulting (general) Service code 16 | — | $21K |
| RICHARD J. WOLF EIN 36-3182363 NONE | Accounting (including auditing) Service code 10 | — | $17K |
| CHEIRON EIN 13-4215617 NONE | Actuarial Service code 11 | — | $12K |
| HINSHAW & CULBERTSON EIN 36-2128133 NONE | Legal Service code 29 | — | $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 | 477 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 151 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 628 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | FORT DEARBORN LIFE INSURANCE COMPANY | 475 | $35K |
| Other | FORT DEARBORN LIFE INSURANCE COMPANY | 475 | $35K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 475 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Filing reports zero broker compensation on a plan over 100 participants. Likely direct-write or unreported — worth a knock.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.