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 |
|---|---|---|---|
| BLUECROSS BLUESHIELD OF ILLINOIS EIN 36-1236610 NONE | Claims processing; Other commissions Service code 12 | — | $1.0M |
| CORPORATE HEALTH DIMENSIONS NONE | Other services Service code 49 | 5500 MARYLAND WAY NO. 400 BRENTWOOD, TN 37027 | $453K |
| CLEARARC CAPITAL, INC. EIN 34-1172683 NONE | Investment management fees paid directly by plan; Investment management; Soft dollars commissions Service code 28 | — | $293K |
| COMPSYCH CORPORATION NONE | Other services Service code 49 | 455 N. CITYFRONT PLAZA CHICAGO, IL 60611 | $263K |
| MEDICAL COST MANAGEMENT EIN 36-3445315 NONE | Other services Service code 49 | — | $233K |
| DELTA DENTAL OF ILLINOIS NONE | Other services Service code 49 | 111 SHUMAN BLVD NAPERVILLE, IL 60563 | $174K |
| MOE IT SERVICE CORPORATION RELATED ORGANIZATION | Other services Service code 49 | 6150 JOLIET RD COUNTRYSIDE, IL 60525 | $133K |
| THE SEGAL COMPANY NONE | Consulting (general); Actuarial Service code 11 | 101 N. WACKER DRIVE, 500 CHICAGO, IL 60606 | $123K |
| CHANGE HEALTHCARE NONE | Other services Service code 49 | 3055 LEBANON PIKE NASHVILLE, TN 37214 | $120K |
| THE NORTHERN TRUST CORPORATION EIN 36-2723087 NONE | Soft dollars commissions; Other investment fees and expenses; Investment management fees paid directly by plan; Custodial (securities); Investment management Service code 19 | — | $59K |
| BOND BROTHERS NONE | Copying and duplicating Service code 36 | 7826 47TH STREET LYONS, IL 60534 | $55K |
| PHARMACEUTICAL STRATEGIES GROUP NONE | Other services Service code 49 | 5360 LEGACY DRIVE STE 230 PLANO, TX 75024 | $50K |
| LEGACY PROFESSIONALS LLP EIN 32-0043599 NONE | Accounting (including auditing) Service code 10 | — | $46K |
| INSTITUTE FOR WORKER WELFARE NONE | Legal Service code 29 | 6141 JOLIET ROAD COUNTRYSIDE, IL 60525 | $42K |
| INNOVATIVE SOFTWARE SOLUTIONS, INC. EIN 23-2182079 NONE | Consulting (general); Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $39K |
| RED CARD SYSTEMS, LLC NONE | Other services Service code 49 | 744 OFFICE PARKWAY SAINT LOUIS, MO 63141 | $34K |
| BRIAN DOXIE EIN 37-1752023 EMPLOYEE | Employee (plan); Non-monetary compensation Service code 30 | — | $34K |
| TRACY BIELA EIN 37-1752023 EMPLOYEE | Employee (plan) Service code 30 | — | $31K |
| THOMAS BERNSTEIN EIN 37-1752023 EMPLOYEE | Plan Administrator; Employee (plan) Service code 14 | — | $31K |
| CHERYL LYNCH EIN 37-1752023 EMPLOYEE | Employee (plan) Service code 30 | — | $30K |
| CVS/CAREMARK, INC. NONE | Claims processing; Other services Service code 12 | ONE CVS DRIVE WOONSOCKET, RI 02895 | $29K |
| KERRY MCMAHON EIN 37-1752023 EMPLOYEE | Employee (plan) Service code 30 | — | $29K |
| MICHELLE FUDALA EIN 37-1752023 EMPLOYEE | Employee (plan) Service code 30 | — | $29K |
| CHERYLE PICKETT EIN 37-1752023 EMPLOYEE | Employee (plan) Service code 30 | — | $29K |
| PAMELA BATTISTA EIN 37-1752023 EMPLOYEE | Employee (plan) Service code 30 | — | $28K |
| HECTOR TAPIA EIN 37-1752023 EMPLOYEE | Employee (plan) Service code 30 | — | $27K |
| FRANCES LIMANDRI-BURGOS EIN 37-1752023 EMPLOYEE | Employee (plan) Service code 30 | — | $26K |
| CONNIE SHONTEE EIN 37-1752023 EMPLOYEE | Employee (plan) Service code 30 | — | $26K |
| JOY BARTH EIN 37-1752023 EMPLOYEE | Employee (plan) Service code 30 | — | $26K |
| ARLENE ORMISTON EIN 37-1752023 EMPLOYEE | Employee (plan) Service code 30 | — | $26K |
| LORI AUNE EIN 37-1752023 EMPLOYEE | Employee (plan) Service code 30 | — | $26K |
| SYLVIA MCAROY EIN 37-1752023 EMPLOYEE | Employee (plan) Service code 30 | — | $26K |
| GREGORY MUDD EIN 37-1752023 EMPLOYEE | Employee (plan) Service code 30 | — | $26K |
| MARIA JOERMS EIN 37-1752023 EMPLOYEE | Employee (plan) Service code 30 | — | $26K |
| SUSAN STELLA EIN 37-1752023 EMPLOYEE | Employee (plan) Service code 30 | — | $25K |
| MARY DAVIS EIN 37-1752023 EMPLOYEE | Employee (plan) Service code 30 | — | $25K |
| MCGANN, KETTERMAN & RIOUX NONE | Legal Service code 29 | 111 EAST WACKER DRIVE, STE 2600 CHICAGO, IL 60601 | $22K |
| MARQUETTE ASSOCIATES NONE | Investment advisory (plan) Service code 27 | 180 NORTH LASALLE ST, SUITE 3500 CHICAGO, IL 60601 | $10K |
| THOMPSON COBURN LLP NONE | Legal Service code 29 | PO BOX 18379 M SAINT LOUIS, MO 63195 | $6K |
| MEDIMEDIA USA, INC NONE | Other services Service code 49 | 19 WEST COLLEGE AVENUE YARDLEY, PA 19067 | $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 | 0 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 7,483 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 7,483 | 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.