No brokers reported on this filing.
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CVS HEALTH NONE | Claims processing; Other commissions; Other fees Service code 12 | ONE CVS DRIVE WOONSOCKET, RI 02895 | $4.8M |
| BLUE CROSS BLUE SHIELD OF ILLINOIS EIN 36-1236610 NONE | Claims processing; Contract Administrator; Participant communication; Non-monetary compensation; Other insurance fees and expenses Service code 12 | — | $574K |
| WILLIAM MANGIN EIN 36-6600740 EMPLOYEE | Plan Administrator Service code 14 | — | $155K |
| MILLIMAN INC EIN 91-0675641 NONE | Actuarial Service code 11 | — | $155K |
| KIMBERLY HATFIELD EIN 36-6600740 EMPLOYEE | Employee (plan) Service code 30 | — | $119K |
| DIANE BOYTE EIN 36-6600740 EMPLOYEE | Employee (plan) Service code 30 | — | $118K |
| NATIONAL INVESTMENT SVC INC EIN 80-0169636 NONE | Investment management; Investment management fees paid directly by plan Service code 28 | — | $117K |
| MARY MCMULLIN EIN 36-6600740 EMPLOYEE | Employee (plan) Service code 30 | — | $113K |
| CYNTHIA KATS EIN 36-6600740 EMPLOYEE | Employee (plan) Service code 30 | — | $112K |
| MAUREEN GLYNN NUDI EIN 36-6600740 EMPLOYEE | Employee (plan) Service code 30 | — | $102K |
| JOHNSON & KROL, LLC EIN 36-4342024 NONE | Legal Service code 29 | — | $94K |
| JENNIFER HILL EIN 36-6600740 EMPLOYEE | Employee (plan) Service code 30 | — | $92K |
| KATIE DWYER EIN 36-6600740 EMPLOYEE | Employee (plan) Service code 30 | — | $90K |
| BASYS, INC EIN 52-1796473 NONE | Other services; Recordkeeping and information management (computing, tabulating, data processing, etc.); Other commissions Service code 15 | — | $89K |
| JACQUELINE CARSON EIN 36-6600740 EMPLOYEE | Employee (plan) Service code 30 | — | $80K |
| ROSEMARY GRIFFIN EIN 36-6600740 EMPLOYEE | Employee (plan) Service code 30 | — | $78K |
| LEGACY PROFESSIONALS LLP EIN 32-0043599 NONE | Accounting (including auditing) Service code 10 | — | $68K |
| JAMES R KLEMME NONE | Accounting (including auditing) Service code 10 | 8159 W. BRYN MAWR CHICAGO, IL 606312940 | $32K |
| STRATEGIC CAPITAL INVEST ADVISORS EIN 36-4268991 NONE | Investment advisory (plan) Service code 27 | — | $24K |
| K-PLUS COMPUTER SERVICES, LLC EIN 36-4282001 NONE | Consulting fees Service code 70 | — | $15K |
| DENTAL NETWORK OF AMERICA, LLC EIN 36-3339483 NONE | Contract Administrator; Claims processing Service code 12 | — | $15K |
| CHANGE HEALTHCARE EIN 20-5716594 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $9K |
| FIRST MIDWEST BANK EIN 36-1495255 NONE | Investment management fees paid directly by plan; Custodial (securities); Investment management Service code 19 | — | $7K |
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 | 853 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 420 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 55 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,328 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | DEARBORN NATIONAL LIFE INSURANCE COMPANY | 838 | $332K |
| Other | DEARBORN NATIONAL LIFE INSURANCE COMPANY | 838 | $332K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 838 | — |
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.