No insurance carriers on this filing. Self-funded welfare plans typically pay TPAs and PBMs through Schedule C, not Schedule A.
No brokers reported on this filing.
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CORPORATE HEALTH DIMENSIONS EIN 23-3057155 NONE | Other services Service code 49 | — | $1.8M |
| MIDWEST COALITION OF LABOR RELATED ORGANIZATION | Other services Service code 49 | 6200 JOLIET ROAD COUNTRYSIDE, IL 60525 | $1.0M |
| BLUECROSS BLUESHIELD OF ILLINOIS EIN 36-1236610 NONE | Claims processing; Other commissions Service code 12 | — | $921K |
| EVERSIDE HEALTH LLC NONE | Other services Service code 49 | DEPT CH 18148 PALATINE, IL 60055 | $791K |
| RED CARD SYSTEMS, LLC NONE | Other services Service code 49 | 744 OFFICE PARKWAY SAINT LOUIS, MO 63141 | $304K |
| MOE IT SERVICE CORPORATION RELATED ORGANIZATION | Other services Service code 49 | 6150 JOLIET RD COUNTRYSIDE, IL 60525 | $231K |
| DELTA DENTAL OF ILLINOIS EIN 36-2612058 NONE | Claims processing Service code 12 | — | $195K |
| VALENZ HEALTH NONE | Other services Service code 49 | 23048 N. 15TH AVENUE PHOENIX, AZ 85027 | $185K |
| UCS HOLDINGS NONE | Other services Service code 49 | DEPT 374, PO BOX 1000 MEMPHIS, TX 38148 | $152K |
| LEGACY PROFESSIONALS LLP EIN 32-0043599 NONE | Accounting (including auditing); Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 10 | — | $107K |
| THE SEGAL COMPANY EIN 13-1975125 NONE | Actuarial Service code 11 | — | $107K |
| ANNA BOZICH EIN 37-1752023 EMPLOYEE | Employee (plan) Service code 30 | — | $94K |
| BRIDGEWAY BENEFIT TECHNOLOGIES, LLC EIN 52-1796473 NONE | Other services Service code 49 | — | $88K |
| BOND BROTHERS & CO. NONE | Copying and duplicating Service code 36 | 7826 47TH STREET LYONS, IL 60534 | $86K |
| ANGELICA AMADOR EIN 37-1752023 EMPLOYEE | Employee (plan) Service code 30 | — | $77K |
| INSTITUTE FOR WORKER WELFARE RELATED ORGANIZATION | Legal Service code 29 | 6141 JOLIET ROAD COUNTRYSIDE, IL 60525 | $77K |
| KELSIE PECENY EIN 37-1752023 EMPLOYEE | Employee (plan) Service code 30 | — | $76K |
| TANYA REED EIN 37-1752023 EMPLOYEE | Employee (plan) Service code 30 | — | $73K |
| JENNIFER MEISTER EIN 37-1752023 EMPLOYEE | Employee (plan); Non-monetary compensation Service code 30 | — | $72K |
| ABSOLUTE SOLUTIONS LLC NONE | Other services Service code 49 | PO BOX 1345 BLOOMINGTON, IL 61702 | $67K |
| FRANCES LIMANDRI-BURGOS EIN 37-1752023 EMPLOYEE | Employee (plan) Service code 30 | — | $66K |
| MATTHEW MOSQUEDA EIN 37-1752023 EMPLOYEE | Employee (plan); Non-monetary compensation Service code 30 | — | $65K |
| MARY DAVIS EIN 37-1752023 EMPLOYEE | Employee (plan) Service code 30 | — | $64K |
| JENNIFER BEEMSTERBOER EIN 37-1752023 EMPLOYEE | Employee (plan) Service code 30 | — | $64K |
| BETTY PHILLIPS EIN 37-1752023 EMPLOYEE | Employee (plan) Service code 30 | — | $59K |
| JACKIE CALDWELL EIN 37-1752023 EMPLOYEE | Employee (plan) Service code 30 | — | $59K |
| CHERYLE PICKETT DENNIS EIN 37-1752023 EMPLOYEE | Employee (plan) Service code 30 | — | $59K |
| NANCY MCKINLEY EIN 37-1752023 EMPLOYEE | Employee (plan) Service code 30 | — | $59K |
| VATISHA HAMMICK EIN 37-1752023 EMPLOYEE | Employee (plan) Service code 30 | — | $58K |
| MARICRUZ CERVANTES EIN 37-1752023 EMPLOYEE | Employee (plan) Service code 30 | — | $58K |
| TONI ROWLAND EIN 37-1752023 EMPLOYEE | Employee (plan) Service code 30 | — | $58K |
| KAITLYN ODEKIRK EIN 37-1752023 EMPLOYEE | Employee (plan) Service code 30 | — | $58K |
| CHRISTINE MOWINSKI EIN 37-1752023 EMPLOYEE | Employee (plan) Service code 30 | — | $57K |
| HECTOR TAPIA EIN 37-1752023 EMPLOYEE | Employee (plan) Service code 30 | — | $57K |
| ALLISON CIANCI EIN 37-1752023 EMPLOYEE | Employee (plan) Service code 30 | — | $56K |
| GENERAL DYNAMICS INFORMATION TECH NONE | Other services Service code 49 | 3150 FAIRVIEW PARK DRIVE FALLS CHURCH, VA 22042 | $56K |
| JULI KRESGE EIN 37-1752023 EMPLOYEE | Employee (plan) Service code 30 | — | $55K |
| MARIE JOERMS EIN 37-1752023 EMPLOYEE | Employee (plan) Service code 30 | — | $54K |
| SYLVIA MCAROY EIN 37-1752023 EMPLOYEE | Employee (plan) Service code 30 | — | $54K |
| BEATA GARCZEK EIN 37-1752023 EMPLOYEE | Employee (plan) Service code 30 | — | $54K |
| LAVERNE PURCHASE EIN 37-1752023 EMPLOYEE | Employee (plan) Service code 30 | — | $54K |
| GILBERT PEREZ EIN 37-1752023 EMPLOYEE | Employee (plan) Service code 30 | — | $54K |
| WANDA BUSS EIN 37-1752023 EMPLOYEE | Employee (plan) Service code 30 | — | $54K |
| JESSIKA PUENTE EIN 37-1752023 EMPLOYEE | Employee (plan) Service code 30 | — | $53K |
| MICHELLE PICCOLO EIN 37-1752023 EMPLOYEE | Employee (plan) Service code 30 | — | $53K |
| ARLENE ORMISTON EIN 37-1752023 EMPLOYEE | Employee (plan) Service code 30 | — | $51K |
| SARAH SMITH EIN 37-1752023 EMPLOYEE | Employee (plan) Service code 30 | — | $48K |
| JESSICA LEWNER EIN 37-1752023 EMPLOYEE | Employee (plan) Service code 30 | — | $47K |
| LUZ CASTILLO EIN 37-1752023 EMPLOYEE | Employee (plan) Service code 30 | — | $46K |
| NINNO SHIELDS EIN 37-1752023 EMPLOYEE | Employee (plan) Service code 30 | — | $46K |
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 | 0 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 8,531 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 8,531 | Active + retired/separated + beneficiaries. No dependents. |
No Schedule A insurance contracts on this filing — typical of fully self-funded plans, where the only headcount is the Form 5500 number above.
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."
Self-funded plan with no stop-loss carrier attached. Catastrophic-risk exposure; stop-loss specialist sales target.