| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| AMWINS5 | 50 WHITECAP DRIVE N. KINGSTON, RI 02852 | EXPRESS SCRIPTS, INC. PRESCRIPTION DRUG PLAN | $11K | — | $11K | 3.60% |
| THE SEGAL COMPANY5 Filed as: THE SEGAL COMPANY (MIDWEST), INC. | 333 WEST 34TH STREET NEW YORK, NY 10001 | EXPRESS SCRIPTS, INC. PRESCRIPTION DRUG PLAN | $7K | — | $7K | 2.40% |
| AMWINS5 | 50 WHITECAP DRIVE N. KINGSTON, RI 02852 | UNITED AMERICAN INSURANCE COMPANY RETIREE MEDICAL | $26K | — | $26K | 10.23% |
| THE SEGAL COMPANY5 Filed as: THE SEGAL COMPANY (MIDWEST), INC. | 333 WEST 34TH STREET NEW YORK, NY 10001 | UNITED AMERICAN INSURANCE COMPANY RETIREE MEDICAL | $9K | — | $9K | 3.41% |
| VISION SERVICE PLAN3 Filed as: VISION SERVICE PLAN OF ILLINOIS | 222 SOUTH RIVERSIDE PLAZA CHICAGO, IL 60606 | VISION SERVICE PLAN OF ILLINOIS | — | $15K | $15K | 8.53% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF ILLINOIS EIN 36-1236610 NONE | Claims processing Service code 12 | — | $664K |
| GROUP ADMINISTRATORS, LTD. EIN 36-3381052 NONE | Contract Administrator; Other commissions Service code 13 | — | $372K |
| THE SEGAL COMPANY (MIDWEST) INC. EIN 13-1975125 NONE | Insurance brokerage commissions and fees; Actuarial Service code 11 | — | $256K |
| ZENITH AMERICAN SOLUTIONS EIN 52-1590516 NONE | Contract Administrator Service code 13 | — | $118K |
| MCGANN KETTERMAN AND RIOUX, LTD EIN 36-3968279 NONE | Legal Service code 29 | — | $104K |
| SEGAL MARCO ADVISORS EIN 13-2646110 NONE | Investment advisory (plan) Service code 27 | — | $70K |
| AMERICAN REALTY ADVISORS EIN 33-0123114 NONE | Investment management fees paid directly by plan; Investment management Service code 28 | — | $69K |
| LEGACY PROFESSIONALS LLP EIN 32-0043599 NONE | Accounting (including auditing) Service code 10 | — | $65K |
| MACNELL ACCOUNTING & CONSULTING LLP EIN 30-0510353 NONE | Accounting (including auditing) Service code 10 | — | $47K |
| AMALGAMATED BANK OF CHICAGO EIN 36-0721895 NONE | Custodial (securities); Float revenue; Other investment fees and expenses Service code 19 | — | $22K |
| INVESCO ADVISORS INC. EIN 58-1707262 NONE | Investment management; Investment management fees paid directly by plan; Float revenue Service code 28 | — | $17K |
| ULLICO INVESTMENT ADVISORS INC. EIN 52-6435649 NONE | Investment management; Investment management fees paid directly by plan; Soft dollars commissions Service code 28 | — | $14K |
| BOND BROTHERS EIN 36-2433269 NONE | Copying and duplicating Service code 36 | — | $7K |
| DAN AUSSEM EIN 36-6599036 TRUSTEE | Trustee (individual) Service code 20 | — | $6K |
| PAUL ARAMBASICH EIN 36-6599036 TRUSTEE | Trustee (individual) Service code 20 | — | $6K |
| DANA OAKS EIN 36-6599036 TRUSTEE | Trustee (individual) Service code 20 | — | $5K |
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 | 1,166 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 294 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 1,460 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITED AMERICAN INSURANCE COMPANY RETIREE MEDICAL | 139 | $256K |
| Vision | VISION SERVICE PLAN OF ILLINOIS | 1,193 | $179K |
| Life insurance | THE UNION LABOR LIFE INSURANCE COMPANY | 1,143 | $28K |
| Prescription drug | EXPRESS SCRIPTS, INC. PRESCRIPTION DRUG PLAN | 140 | $302K |
| Stop-loss / reinsurancereinsurance | THE UNION LABOR LIFE INSURANCE COMPANY | 1,378 | $1.2M |
| Other | THE UNION LABOR LIFE INSURANCE COMPANY | 1,143 | $28K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,378 | — |
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.