| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ELITE ADMINISTRATION3 Filed as: ELITE ADMINISTRATION & INSURANCE GR | 1300 W. HIGGINS, SUITE 208 PARK RIDGE, IL 60068 | NATIONWIDE LIFE INSURANCE | $214K | $0 | $214K | 10.00% |
| ELITE ADMINISTRATION3 | 1211 W 22ND ST, STE 820 OAK BROOK, IL 60523 | DEARBORN NATIONAL LIFE INSURANCE COMPANY | $19K | $10K | $29K | 7.33% |
| ELITE ADMINISTRATION3 | 1211 W 22ND ST, STE 820 OAK BROOK, IL 60523 | STANDARD INSURANCE COMPANY | $8K | $2K | $10K | 11.94% |
| ELITE ADMINISTRATION3 | 1211 W 22ND ST, STE 820 OAK BROOK, IL 605233223 | STANDARD INSURANCE COMPANY | $6K | $4K | $9K | 13.80% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS AND BLUE SHIELD EIN 36-1236610 NONE | Claims processing Service code 12 | — | $945K |
| ELITE ADMINISTRATION EIN 36-2238689 NONE | Claims processing; Insurance brokerage commissions and fees Service code 12 | — | $543K |
| SAV-RX EIN 47-0527013 NONE | Contract Administrator Service code 13 | — | $143K |
| LOCAL 3 SALES PENSION EIN 36-6527340 RELATED FUND | Other services Service code 49 | — | $99K |
| LOCAL 3 UNION EIN 36-4044987 RELATED UNION | Other services Service code 49 | — | $97K |
| HOPE EMPLOYEE ASSISTANCE EIN 81-1574820 NONE | Other fees Service code 99 | — | $79K |
| MARIO FIORITO EIN 36-3265979 EMPLOYEE | Employee (plan) Service code 30 | — | $75K |
| MEDCARE MANAGEMENT EIN 88-0429522 NONE | Consulting (general) Service code 16 | — | $62K |
| FLORENCE MARTINEZ EIN 36-3265979 EMPLOYEE | Employee (plan) Service code 30 | — | $48K |
| JAMES HENRY DUFF EIN 36-1802277 EMPLOYEE | Employee (plan) Service code 30 | — | $48K |
| CALIBRE CPA GROUP EIN 47-0900880 NONE | Accounting (including auditing) Service code 10 | — | $24K |
| DENTAL NETWORK OF AMERICA EIN 36-3339483 NONE | Claims processing Service code 12 | — | $22K |
| KEEBECK WEALTH MANAGEMENT EIN 83-0689199 NONE | Investment management fees paid directly by plan Service code 51 | — | $18K |
| PROFESSIONAL ACCOUNTING SERVICES EIN 92-1530140 NONE | Accounting (including auditing) Service code 10 | — | $18K |
| BELMONT BANK NONE | Trustee (bank, trust company, or similar financial institution) Service code 21 | 8250 W BELMONT AVENUE CHICAGO, IL 60634 | $9K |
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 | 2,172 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 14 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 2,186 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance(3 contracts, 2 carriers) | DEARBORN NATIONAL LIFE INSURANCE COMPANY | 2,186 | $545K |
| Long-term disability | DEARBORN NATIONAL LIFE INSURANCE COMPANY | 2,186 | $397K |
| Stop-loss / reinsurancereinsurance | NATIONWIDE LIFE INSURANCE | 2,186 | $2.1M |
| Other | STANDARD INSURANCE COMPANY | 2,186 | $80K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,186 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.