| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| THOMAS J MITCHELL3 | 2704 RICHARDSON DRIVE SPRINGFIELD, IL 62711 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $8K | — | $8K | 15.00% |
| THOMAS J MITCHELL3 | 2704 RICHARDSON DRIVE SPRINGFIELD, IL 62711 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $91 | — | $91 | 15.02% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HEALTHLINK, INC EIN 43-1364135 NONE | Other fees; Other services; Direct payment from the plan Service code 49 | — | $172K |
| EMPLOYEE 2 EIN 37-1037101 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $146K |
| EMPLOYEE 3 EIN 37-1037101 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $109K |
| EMPLOYEE 6 EIN 37-1037101 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $103K |
| EMPLOYEE 1 EIN 37-1037101 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $90K |
| EMPLOYEE 9 EIN 37-1037101 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $84K |
| EMPLOYEE 10 EIN 37-1037101 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $81K |
| EMPLOYEE 13 EIN 37-1037101 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $79K |
| EMPLOYEE 5 EIN 37-1037101 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $77K |
| EMPLOYEE 14 EIN 37-1037101 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $72K |
| EMPLOYEE 12 EIN 37-1037101 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $71K |
| EMPLOYEE 8 EIN 37-1037101 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $63K |
| MIDWEST REGION HEALTH & SAFETY FUND EIN 37-1384481 NONE | Other services; Direct payment from the plan Service code 49 | — | $52K |
| EMPLOYEE 7 EIN 37-1037101 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $51K |
| LDI INTEGRATED PHARMACY SERVICES NONE | Claims processing; Other services; Direct payment from the plan Service code 12 | 701 EMERSON RD, STE 301 CREVE COEUR, MO 63141 | $50K |
| EMPLOYEE 4 EIN 37-1037101 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $47K |
| CENTRAL LABORERS PENSION FUND EIN 37-6052379 NONE | Direct payment from the plan; Other services Service code 49 | — | $41K |
| CAVANAGH & OHARA, LLP EIN 37-1259635 NONE | Legal; Direct payment from the plan Service code 29 | — | $33K |
| PERSPECTIVES, LTD EIN 36-3444982 NONE | Direct payment from the plan; Other fees Service code 50 | — | $28K |
| ROCKWOOD CAPITAL ADVISORS NONE | Accounting (including auditing); Other investment fees and expenses; Direct payment from the plan Service code 10 | 721 EMERSON ROAD, SUITE 565 ST. LOUIS, MO 63141 | $28K |
| UNITED ACTUARIAL SERVICES, INC EIN 35-2156428 NONE | Direct payment from the plan; Actuarial Service code 11 | — | $27K |
| ROMOLO & ASSOCIATES EIN 37-1077733 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $26K |
| MCDONNELL INVESTMENT EIN 46-1057753 NONE | Investment management; Other investment fees and expenses; Securities brokerage; Investment management fees paid directly by plan Service code 28 | — | $20K |
| RSM US LLP EIN 42-0714325 NONE | Consulting (general); Direct payment from the plan Service code 16 | — | $16K |
| MARQUETTE ASSOCIATES EIN 36-3485298 NONE | Investment advisory (plan); Direct payment from the plan Service code 27 | — | $12K |
| MILLIMAN NONE | Actuarial; Direct payment from the plan Service code 11 | 500 NORTH BOARDWAY SUITE 1750 ST. LOUIS, MO 63102 | $8K |
| THL CREDIT SENIOR LOAN STRATEGIES EIN 90-0789283 NONE | Investment management fees paid indirectly by plan; Investment management Service code 28 | — | $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 | 1,081 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 14 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 1,095 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance(2 contracts) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 1,161 | $56K |
| Stop-loss / reinsurancereinsurance | FIDELITY SECURITY LIFE | 1,323 | $369K |
| Other(2 contracts) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 1,161 | $56K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,323 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.