| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| THOMAS J MITCHELL3 | 2704 RICHARDSON DRIVE SPRINGFIELD, IL 62711 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $2K | — | $2K | 4.44% |
| THOMAS J MITCHELL3 | 2704 RICHARDSON DRIVE SPRINGFIELD, IL 62711 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $28 | — | $28 | 4.68% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| EMPLOYEE 2 EIN 37-1037101 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $144K |
| EMPLOYEE 6 EIN 37-1037101 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $132K |
| EMPLOYEE 5 EIN 37-1037101 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $114K |
| EMPLOYEE 3 EIN 37-1037101 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $110K |
| EMPLOYEE 9 EIN 37-1037101 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $97K |
| HEALTHLINK, INC EIN 43-1364135 NONE | Direct payment from the plan; Other services; Other fees Service code 49 | — | $95K |
| EMPLOYEE 4 EIN 37-1037101 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $89K |
| EMPLOYEE 7 EIN 37-1037101 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $89K |
| EMPLOYEE 1 EIN 37-1037101 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $84K |
| EMPLOYEE 8 EIN 37-1037101 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $79K |
| EMPLOYEE 10 EIN 37-1037101 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $75K |
| MIDWEST REGION HEALTH & SAFETY FUND EIN 37-1384481 NONE | Direct payment from the plan; Other services Service code 49 | — | $63K |
| UNITED ACTUARIAL SERVICES, INC EIN 35-2156428 NONE | Actuarial; Direct payment from the plan Service code 11 | — | $42K |
| CENTRAL LABORERS PENSION FUND EIN 37-6052379 NONE | Other services; Direct payment from the plan Service code 49 | — | $37K |
| SAVRX EIN 47-0527013 NONE | Direct payment from the plan; Other services Service code 49 | 224 NORTH PARK AVENUE FREMONT, NE 68025 | $33K |
| ROMOLO & ASSOCIATES EIN 37-1077733 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $27K |
| CAVANAGH & OHARA, LLP EIN 37-1259635 NONE | Legal; Direct payment from the plan Service code 29 | — | $22K |
| PERSPECTIVES, LTD EIN 36-3444982 NONE | Direct payment from the plan; Other fees Service code 50 | — | $21K |
| CASTIA RX EIN 81-3741657 NONE | Other services; Direct payment from the plan; Claims processing Service code 12 | 701 EMERSON RD, STE 301 CREVE COEUR, MO 63141 | $15K |
| MARQUETTE ASSOCIATES EIN 36-3485298 NONE | Investment advisory (plan); Direct payment from the plan Service code 27 | — | $10K |
| MILLIMAN EIN 91-0675641 NONE | Direct payment from the plan; Actuarial Service code 11 | 500 NORTH BOARDWAY SUITE 1750 ST. LOUIS, MO 63102 | $8K |
| THL CREDIT SENIOR LOAN STRATEGIES EIN 90-0789283 NONE | Investment management; Investment management fees paid indirectly by plan Service code 28 | — | $6K |
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 | 824 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 6 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 830 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance(2 contracts) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 920 | $48K |
| Stop-loss / reinsurancereinsurance | THE UNION LABOR LIFE INSURANCE COMPANY | 972 | $280K |
| Other(2 contracts) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 920 | $48K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 972 | — |
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.