| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| THE SEGAL COMPANY4 | 101 N WACKER DRIVE CHICAGO, IL 60606 | NATIONWIDE LIFE INSURANCE COMPANY | $17K | — | $17K | 6.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HEALTH CARE SERVICE CORPORATION EIN 36-1236610 NONE | Claims processing Service code 12 | — | $295K |
| GROUP ADMINISTRATORS LTD EIN 36-3381052 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.); Contract Administrator; Claims processing Service code 12 | 915 NATIONAL PARKWAY SCHAUMBURG, IL 60173 | $257K |
| THE SEGAL COMPANY EIN 13-1975125 NONE | Consulting (general) Service code 16 | 101 N WACKER DR, SUITE 500 CHICAGO, IL 60606 | $96K |
| CALIBRE CPA GROUP, PLLC EIN 47-0900880 NONE | Accounting (including auditing) Service code 10 | 230 W MONROE ST, SUITE 310 CHICAGO, IL 60606 | $50K |
| STRATEGIC CAPITAL INVESTMENT ADVISO EIN 36-4268991 NONE | Investment advisory (plan) Service code 27 | — | $25K |
| BAUM SIGMAN AUERBACH & NEUMAN, LTD EIN 36-2744057 NONE | Legal Service code 29 | 200 WEST ADAMS ST, SUITE 2200 CHICAGO, IL 60606 | $17K |
| HINES & ASSOCIATES EIN 36-3545085 NONE | Consulting (general) Service code 16 | 115 EAST HIGHLAND AVE ELGIN, IL 60120 | $17K |
| EMPLOYEE RESOURCE SYSTEMS EIN 36-3867645 NONE | Consulting (general) Service code 16 | 29 E MADISON, SUITE 1600 CHICAGO, IL 60602 | $12K |
| NORTHERN TRUST EIN 36-1561860 NONE | Custodial (securities) Service code 19 | 50 S LASALLE ST CHICAGO, IL 60690 | $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 | 499 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 147 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 646 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 502 | $57K |
| Prescription drug | HUMANA INSURANCE | 200 | $311K |
| Stop-loss / reinsurancereinsurance | NATIONWIDE LIFE INSURANCE COMPANY | 592 | $284K |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 502 | $57K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 592 | — |
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."
No prospect flags tripped on this filing.