| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| FRINGE FUNDING, INC.3 | ONE CROSSROADS OF COMMERCE DR. SUITE 615 ROLLING MEADOW, IL 60008 | HEALTH CARE SERVICE CORPORATION (BLUE CROSS BLUE SHIELD) | — | — | $0 | 0.00% |
| DAVID O'HARA3 | FRINGE FUNDING, INC. 3601 ALGONQUIN ROAD, SUITE 615 ROLLING MEADOWS, IL 60008 | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $595 | — | $595 | 14.99% |
| LANNY D. LEVIN AGENCY, INC.3 | 1751 LAKE COOK ROAD SUITE 350 DEERFIELD, IL 60015 | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $6 | — | $6 | 0.15% |
| MARK METTILLE3 Filed as: MARK C. PIETSCH | 10816 CRYSTAL SPRINGS LANE ORLAND PARK, IL 60467 | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $3 | — | $3 | 0.08% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| GROUP ADMINISTRATORS, LTD EIN 36-3381052 CONTRACT ADMIN ISTRATOR | Direct payment from the plan; Contract Administrator; Claims processing Service code 12 | — | $109K |
| STUDIO MECHANICS LOCAL 476 EIN 36-2088664 EMPLOYER ORGAN IZATION/UN | Plan Administrator; Direct payment from the plan Service code 14 | — | $63K |
| FRINGE FUNDING EIN 36-3177386 INSURANCE BROKER | Direct payment from the plan; Insurance services; Consulting (general) Service code 16 | — | $36K |
| WAMPLER & ASSOCIATES, LLC EIN 32-0106897 ACCOUNTANT | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $31K |
| FGMK, LLC EIN 36-2929601 AUDITOR | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $14K |
| JACOB BURNS, ORLOVE & HERNANDEZ EIN 36-2425981 LAWYER | Legal; Direct payment from the plan Service code 29 | — | $11K |
| COMERICA BANK EIN 36-6602783 INVESTMENT CUSTODIAN | Investment management; Float revenue; Other fees; Other investment fees and expenses; Direct payment from the plan; Shareholder servicing fees; Other services; Custodial (securities) Service code 19 | — | $7K |
| TED WINDSOR & ASSOCIATES EIN 36-4374704 ACTUARY | Actuarial; Direct payment from the plan Service code 11 | — | $6K |
| STRATEGIC CAPITAL INVESTMENT ADVISO EIN 36-4268991 INVESTMENT ADVISOR | Investment advisory (plan); Direct payment from the plan Service code 27 | — | $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 | 452 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 34 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 486 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HEALTH CARE SERVICE CORPORATION (BLUE CROSS BLUE SHIELD) | 0 | $3.3M |
| Life insurance | THE UNION LABOR LIFE INSURANCE COMPANY | 458 | $58K |
| Long-term disability | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 0 | $4K |
| Prescription drug | HEALTH CARE SERVICE CORPORATION (BLUE CROSS BLUE SHIELD) | 0 | $3.3M |
| Stop-loss / reinsurancereinsurance | UNIMERICA INSURANCE COMPANY (OPTUM) | 507 | $699K |
| Other | THE UNION LABOR LIFE INSURANCE COMPANY | 458 | $58K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 507 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.