Form 5500 · Employee benefit plan · HOFFMAN ESTATES, IL
TRANSFORM MIDCO LLC
The filing calls this plan TRANSFORM HEALTH AND WELFARE PLAN.
TRANSFORM MIDCO LLC of HOFFMAN ESTATES, IL spreads its employee benefits across 15 insurance carriers, according to its Form 5500 Schedule A. Its broker of record is STRATEGIC NON-MEDICAL SOLUTIONS LLC. Coverage is written through BLUECROSS BLUESHIELD OF ILLINOIS and 14 other carriers. The plan's most recent policy period ended in December.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 83-3374195 · plan 501 · plan year 2025, filed Jul 30, 2026
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2,668 other employer plans in Illinois have policy years ending in December. See the full list on the renewal calendar, or ask for it in Claude or ChatGPT.
How this plan is funded
Fully insured as reported
The filing reports medical coverage through an insurance contract on Schedule A, and no money paid for benefits by the plan itself.
Benefits declared on this filing
Also declared: severance, death benefits, other welfare.
Declared benefits are the plan’s own line 8b codes on Form 5500. “Not on Schedule A” means no insured contract for that line appears on this filing. That usually means the benefit is self-funded, or it sits under a different plan number.
Where a line has more than one insured contract, the carrier and the covered figure are the largest contract's by premium. The contracts are not added up: a pharmacy carve-out and the medical carrier beside it cover the same people.
Persons covered is the count the carrier filed for that policy at the end of its policy year, and it can include dependents. Participants is the plan's own count at the start of its plan year. The two count different people, so a covered figure can be larger.
Plan brief
Schedule A lists 25 insured contracts covering health, dental, vision, life and disability; the largest, with BLUECROSS BLUESHIELD OF ILLINOIS, covers 2,205 people.
Reported premium across the insured contracts is $20,933,044, with $138,594 in disclosed broker commissions — about 0.7% of premium.
The health contract's policy period ended in December, while at least one ancillary line's policy period ended in April. The plan is on a split renewal cycle.
STRATEGIC NON-MEDICAL SOLUTIONS LLC is the broker of record on 10 of the 25 contracts; the rest name a different broker or none.
15 carriers appear on the filing, including BLUECROSS BLUESHIELD OF ILLINOIS, METROPOLITAN LIFE INSURANCE COMPANY, KAISER FOUNDATION HEALTH PLAN, INC. and TRIPLE S SALUD, INC.. BLUECROSS BLUESHIELD OF ILLINOIS writes the largest contract by premium.
Schedule A insurance contracts
Premium and claims on this contract
BLUECROSS BLUESHIELD OF ILLINOIS, contract 248606. For the contract year on this filing, the carrier reported $15,155,708 in premium earned and $14,199,186 in claims incurred. Dividing one by the other gives 94%.
- BLUECROSS BLUESHIELD OF ILLINOIS, contract 248606 reported $956,522 in retention.
Retention is what the carrier kept of the premium after claims, as reported: administration, commissions and other charges.
Only experience-rated contracts report these figures, so most filings leave them blank.
Covered = persons covered at policy year end, as filed on Schedule A for that policy — often certificates or one class, not the whole plan. Premium = the filing’s own premium/charges figure; “—” means not credibly reported.
Administrator and service providers
The plan administrator is from line 3a of the main form. We publish company names only.
Other plans filed by this employer
How this plan compares
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Renewal calendar
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