| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MESIROW INSURANCE SERVICES INC3 Filed as: MESIROW INSURANCE SERVICES | — | FIDELITY SECURITY LIFE INSURANCE COMPANY | $6K | — | $6K | 2.00% |
| MESIROW INSURANCE SERVICES INC3 | — | DEARBORN NATIONAL LIFE INSURANCE CO | $4K | $3K | $7K | 6.93% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HEALTH CARE SERVICE CORPORATION EIN 36-1236610 NONE | Other fees; Contract Administrator Service code 13 | — | $204K |
| BENEFIT MANAGEMENT GROUP, INC. EIN 20-0188125 NONE | Contract Administrator Service code 13 | — | $160K |
| TSEU LOCAL NO. 2 EIN 36-0906745 RELATED ORGANIZATION | Trustee (discretionary) Service code 24 | — | $63K |
| SEI INVESTMENTS EIN 23-1707341 NONE | Investment management fees paid directly by plan; Investment management Service code 28 | — | $34K |
| GUARDIAN EIN 13-5123390 NONE | Contract Administrator Service code 13 | — | $32K |
| FOSTER & FOSTER EIN 59-1921114 NONE | Actuarial Service code 11 | — | $30K |
| BANSLEY & KIENER EIN 36-2152389 NONE | Accounting (including auditing) Service code 10 | — | $24K |
| MED-CARE MANAGEMENT INC EIN 88-0429522 NONE | Other services Service code 49 | — | $17K |
| SCRIPT CARE, LTD EIN 76-0621375 NONE | Other services Service code 49 | — | $15K |
| JACOB, BURNS, ORLOVE, HERNANDEZ EIN 36-2425981 NONE | Legal Service code 29 | — | $10K |
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 | 522 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 99 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 9 | Vested but not currently using benefits. |
| Beneficiaries receiving benefits | 9 | Spouses or dependents with eligibility independent of the participant. |
| Total participants (= "Plan participants" tile) | 630 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | THE GUARDIAN LIFE INSURANCE CO OF AMERICA | 609 | $32K |
| Life insurance | DEARBORN NATIONAL LIFE INSURANCE CO | 571 | $100K |
| Stop-loss / reinsurancereinsurance | FIDELITY SECURITY LIFE INSURANCE COMPANY | 588 | $316K |
| Other | DEARBORN NATIONAL LIFE INSURANCE CO | 571 | $100K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 609 | — |
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.