| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| THE PLEXUS GROUPE LLC3 | 21805 FIELD PARKWAY SUITE 300 DEER PARK, IL 60010 | BLUECROSS BLUESHIELD OF OKLAHOMA | $108K | — | $108K | 3.13% |
| THE PLEXUS GROUPE LLC3 | 21805 FIELD PARKWAY SUITE 300 DEER PARK, IL 60010 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $53K | — | $53K | 19.00% |
| AXA ASSISTANCE, USA3 | 122 SOUTH MICHIGAN AVENUE SUITE 100 CHICAGO, IL 60603 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $153 | $153 | 0.05% |
| THE PLEXUS GROUPE LLC3 | 21805 FIELD PARKWAY SUITE 300 DEER PARK, IL 60010 | VISION SERVICE PLAN | $13K | — | $13K | 9.97% |
| THE PLEXUS GROUPE LLC3 | 21805 FIELD PARKWAY SUITE 300 DEER PARK, IL 60010 | TELEDOC | $4K | — | $4K | 16.09% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| PRUDENTIAL INSURANCE CO OF AMERICA EIN 22-1211670 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | — | $11K |
| DISCOVERY BENEFITS EIN 90-0058554 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | — | $10K |
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 | 411 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 411 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUESHIELD OF OKLAHOMA | 926 | $3.4M |
| Dental | DELTA DENTAL | 374 | $347K |
| Vision | VISION SERVICE PLAN | 337 | $130K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 411 | $278K |
| Short-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 411 | $278K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 411 | $278K |
| Other(3 contracts, 3 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 411 | $310K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 926 | — |
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."
No prospect flags tripped on this filing.