No brokers reported on this filing.
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HEALTH CARE SERVICES CORP(BC/BS) EIN 36-1236610 NONE | Claims processing Service code 12 | — | $792K |
| SEI INVESTMENTS EIN 23-1707341 NONE | Investment management fees paid directly by plan; Investment management; Investment management fees paid indirectly by plan Service code 28 | — | $337K |
| HINES & ASSOCIATES, INC. EIN 36-3545085 NONE | Consulting (general) Service code 16 | — | $284K |
| HORIZON ACTUARIAL SERVICES, LLC EIN 26-1370698 NONE | Actuarial; Consulting (general) Service code 11 | — | $225K |
| PALMER, TANYA EIN 36-6219639 EMPLOYEE | Employee (plan) Service code 30 | — | $151K |
| JOANNA LOPEZ EIN 36-6219639 EMPLOYEE | Employee (plan) Service code 30 | — | $131K |
| CVS HEALTH EIN 05-0340626 NONE | Claims processing Service code 12 | — | $126K |
| ELINA LLAMAS EIN 36-6219639 EMPLOYEE | Employee (plan) Service code 30 | — | $124K |
| DEBORAH FRENCH EIN 36-6219639 EMPLOYEE | Employee (plan) Service code 30 | — | $116K |
| CALIBRE CPA GROUP, PLLC EIN 47-0900880 NONE | Accounting (including auditing) Service code 10 | — | $102K |
| DAISY ALVARADO EIN 36-6219639 EMPLOYEE | Employee (plan) Service code 30 | — | $91K |
| BRIDGEWAY BENEFIT TECHNOLOGIES EIN 52-1796473 NONE | Consulting (general) Service code 16 | — | $91K |
| DIAZ, MARIA EIN 36-6219639 EMPLOYEE | Employee (plan) Service code 30 | — | $89K |
| BAUM SIGMAN AUERBACH & NEUMAN, LTD. EIN 36-2744057 NONE | Legal Service code 29 | — | $89K |
| DAVID UGARTE EIN 36-6219639 EMPLOYEE | Employee (plan) Service code 30 | — | $65K |
| CIMINO, MICHELE A EIN 36-6219639 EMPLOYEE | Employee (plan) Service code 30 | — | $62K |
| NORTHERN TRUST CO EIN 36-1561860 NONE | Custodial (securities) Service code 19 | — | $59K |
| ALEJANDRES, ALEXANDRIA EIN 36-6219639 EMPLOYEE | Employee (plan) Service code 30 | — | $52K |
| ALLEGRA COAL CITY EIN 32-0447805 NONE | Copying and duplicating Service code 36 | — | $51K |
| DENTAL NETWORK OF AMERICA EIN 36-3339483 NONE | Claims processing Service code 12 | — | $47K |
| EMPLOYEE RESOURCE SYSTEMS, INC. EIN 36-3867645 NONE | Other services Service code 49 | — | $36K |
| NORTHERN PRINT NETWORK EIN 36-3363479 NONE | Copying and duplicating Service code 36 | — | $17K |
| BMI AUDIT SERVICES, LLC EIN 38-4091484 NONE | Other services Service code 49 | — | $16K |
| EYEMED VISION CARE, INC. EIN 31-1656473 NONE | Claims processing Service code 12 | — | $12K |
| IKON SOFTWARE INC. EIN 36-4329379 NONE | Consulting (general) Service code 16 | — | $12K |
| AUTOMATIC DATA PROCESSING, INC. NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | 408 S. SHELBY ST. HOBART, IN 46342 | $7K |
| GREEN LIGHT COST MANAGEMENT, LLC EIN 45-5248276 NONE | Other services Service code 49 | — | $7K |
| BASSLER & CO INSURANCE AGENCY NONE | Insurance brokerage commissions and fees Service code 53 | 611 ACADEMY DR NORTHBROOK, IL 60062 | $4K |
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 | 1,513 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 562 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 2,075 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Stop-loss / reinsurancereinsurance | THE UNION LABOR LIFE INSURANCE COMPANY | 1,845 | $287K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,845 | — |
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.