| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| VISION SERVICE PLAN3 | 3333 QUALITY DRIVE RANCHO CORDOVA, CA 95670 | VISION SERVICE PLAN | — | $220K | $220K | 11.29% |
| VISION SERVICE PLAN3 | 3333 QUALITY DRIVE RANCHO CORDOVA, CA 95670 | VISION SERVICE PLAN | — | $84K | $84K | 16.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD EIN 36-1236610 NONE | Non-monetary compensation; Claims processing; Other insurance fees and expenses; Contract Administrator Service code 12 | — | $7.3M |
| PREMISE HEALTH SYSTEMS, INC. EIN 23-3057155 NONE | Contract Administrator Service code 13 | — | $2.0M |
| EXPRESS SCRIPTS EIN 43-1420563 NONE | Contract Administrator; Claims processing Service code 12 | — | $789K |
| WELLINGTON TRUST COMPANY EIN 04-2755549 NONE | Soft dollars commissions; Investment management fees paid directly by plan; Investment management Service code 28 | — | $729K |
| MCGANN KETTERMAN & RIOUX EIN 36-3968279 NONE | Legal Service code 29 | — | $618K |
| LEGACY PROFESSIONALS, LLP EIN 32-0043599 NONE | Accounting (including auditing) Service code 10 | — | $591K |
| LYRA HEALTH, INC. EIN 47-2935915 NONE | Claims processing Service code 12 | — | $464K |
| OPTUM FINANCIAL EIN 46-0891463 NONE | Claims processing; Other fees Service code 12 | — | $355K |
| SEGAL EIN 13-1975125 NONE | Consulting (general); Actuarial Service code 11 | — | $346K |
| AMALGAMATED BANK OF CHICAGO EIN 36-0721895 NONE | Float revenue; Investment management; Custodial (securities); Investment management fees paid directly by plan Service code 19 | — | $287K |
| DELTA DENTAL OF ILLINOIS EIN 36-2612058 NONE | Claims processing Service code 12 | — | $248K |
| REMKE PRINTING, INC. EIN 36-3840374 NONE | Copying and duplicating Service code 36 | — | $206K |
| V HALSELL EIN 36-6130207 EMPLOYEE | Employee (plan) Service code 30 | — | $203K |
| K GUASTAFERRI EIN 36-6130207 EMPLOYEE | Employee (plan) Service code 30 | — | $202K |
| SEGALL BRYANT & HAMILL, LLC EIN 35-2679129 NONE | Investment management; Investment management fees paid directly by plan Service code 28 | — | $184K |
| N DIAZ EIN 36-6130207 EMPLOYEE | Employee (plan) Service code 30 | — | $174K |
| S CORNEJO-MAGANA EIN 36-6130207 EMPLOYEE | Employee (plan) Service code 30 | — | $154K |
| S GALINDO EIN 36-6130207 EMPLOYEE | Employee (plan) Service code 30 | — | $154K |
| ABSOLUTE SOLUTIONS, LLC EIN 27-3584158 NONE | Contract Administrator Service code 13 | — | $151K |
| L POWELL EIN 36-6130207 EMPLOYEE | Employee (plan) Service code 30 | — | $149K |
| L CRAVION EIN 36-6130207 EMPLOYEE | Employee (plan) Service code 30 | — | $148K |
| REINHART BOERNER VAN DEUREN SC EIN 39-1126909 NONE | Legal Service code 29 | — | $147K |
| B LESTERS EIN 36-6130207 EMPLOYEE | Employee (plan) Service code 30 | — | $146K |
| M CRESPO EIN 36-6130207 EMPLOYEE | Employee (plan) Service code 30 | — | $137K |
| S RIVERA EIN 36-6130207 EMPLOYEE | Employee (plan) Service code 30 | — | $134K |
| A GAINES EIN 36-6130207 EMPLOYEE | Employee (plan) Service code 30 | — | $133K |
| A BEDOLLA EIN 36-6130207 EMPLOYEE | Employee (plan) Service code 30 | — | $132K |
| T DROGOS EIN 36-6130207 EMPLOYEE | Employee (plan) Service code 30 | — | $129K |
| D DREW EIN 36-6130207 EMPLOYEE | Employee (plan) Service code 30 | — | $128K |
| M ZAMUDIO EIN 36-6130207 EMPLOYEE | Employee (plan) Service code 30 | — | $128K |
| K DIAZ EIN 36-6130207 EMPLOYEE | Employee (plan) Service code 30 | — | $123K |
| M MOLLOY EIN 36-6130207 EMPLOYEE | Employee (plan) Service code 30 | — | $122K |
| M OLLIE EIN 36-6130207 EMPLOYEE | Employee (plan) Service code 30 | — | $120K |
| M HERRINGTON EIN 36-6130207 EMPLOYEE | Employee (plan) Service code 30 | — | $120K |
| T PARSON EIN 36-6130207 EMPLOYEE | Employee (plan) Service code 30 | — | $120K |
| L MARTINEZ EIN 36-6130207 EMPLOYEE | Employee (plan) Service code 30 | — | $120K |
| B RADTKE EIN 36-6130207 EMPLOYEE | Employee (plan) Service code 30 | — | $120K |
| S STIGLER EIN 36-6130207 EMPLOYEE | Employee (plan) Service code 30 | — | $120K |
| D MCGHEE EIN 36-6130207 EMPLOYEE | Employee (plan) Service code 30 | — | $119K |
| L JONES EIN 36-6130207 EMPLOYEE | Employee (plan) Service code 30 | — | $117K |
| S OLINGER EIN 36-6130207 EMPLOYEE | Employee (plan) Service code 30 | — | $116K |
| MCJESSY CHING & THOMPSON, LLC EIN 59-3776245 NONE | Legal Service code 29 | — | $115K |
| R KELLEY EIN 36-6130207 EMPLOYEE | Employee (plan) Service code 30 | — | $115K |
| A WOLOSZCZUK EIN 36-6130207 EMPLOYEE | Employee (plan) Service code 30 | — | $115K |
| R WEGNER EIN 36-6130207 EMPLOYEE | Employee (plan) Service code 30 | — | $112K |
| J BALLENTINE EIN 36-6130207 EMPLOYEE | Employee (plan) Service code 30 | — | $109K |
| S MUNOZ EIN 36-6130207 EMPLOYEE | Employee (plan) Service code 30 | — | $107K |
| BRIDGEWAY BENEFIT TECHNOLOGIES EIN 52-1796473 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $106K |
| K GARCIA EIN 36-6130207 NONE | Employee (plan) Service code 30 | — | $105K |
| M AVILA EIN 36-6130207 EMPLOYEE | Employee (plan) Service code 30 | — | $104K |
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 | 11,635 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 8,366 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 20,001 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF ILLINOIS | 20,001 | $195.8M |
| Vision(2 contracts) | VISION SERVICE PLAN | 23,278 | $2.5M |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 20,001 | $1.9M |
| Other | HARTFORD LIFE AND ACCIDENT | 20,001 | $1.9M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 23,278 | — |
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."
Broker comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.