| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ELITE ADMINISTRATION3 Filed as: ELITE ADMINISTRATION & INS GROUP | 1211 W. 22ND STREET STE 820 OAK BROOK, IL 60523 | GERBER LIFE INSURANCE | $290K | — | $290K | 11.00% |
| ELITE ADMINISTRATION3 Filed as: ELITE ADMINISTRATION & INS GROUP | 1211 W. 22ND STREET SUITE 820 OAK BROOK, IL 60523 | VISION SERVICE PLAN | $58K | — | $58K | 5.00% |
| ELITE ADMINISTRATION3 Filed as: ELITE ADMINISTRATION & INS GROUP | 1211 W. 22ND STREET STE 820 OAK BROOK, IL 60523 | DEARBORN NATIONAL LIFE INSURANCE COMPANY | $53K | $36K | $89K | 16.71% |
| ELITE ADMINISTRATION3 Filed as: ELITE ADMINISTRATION & INS GROUP | 1211 W. 22ND STREET STE 820 OAK BROOK, IL 60523 | DEARBORN NATIONAL LIFE INSURANCE COMPANY | $3K | $46 | $4K | 10.13% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HEALTH CARE SERVICE CORPORATION EIN 36-1236610 NONE | Claims processing Service code 12 | — | $2.4M |
| ELITE ADMINISTRATION & INSURANCE EIN 36-2338689 NONE | Other commissions; Claims processing; Insurance brokerage commissions and fees; Recordkeeping fees; Other fees Service code 12 | — | $1.0M |
| HEALTH MANAGEMENT CONCEPTS, INC. EIN 75-3189468 NONE | Other fees Service code 99 | — | $406K |
| WILLIG, WILLIAMS & DAVIDSON EIN 23-2416488 NONE | Legal Service code 29 | — | $315K |
| W. COLI EIN 36-6069119 FUND ADMINISTRATOR | Plan Administrator Service code 14 | — | $221K |
| BANSLEY AND KIENER, L.L.P. EIN 36-2152389 NONE | Other fees; Accounting (including auditing) Service code 10 | — | $166K |
| M. PRYOR EIN 36-6069119 EMPLOYEE | Employee (plan) Service code 30 | — | $131K |
| S. JOHNSON EIN 36-6069119 EMPLOYEE | Employee (plan) Service code 30 | — | $130K |
| ILLINOIS ADVOCATES LLC EIN 46-1047517 OWNER IS SON OF TRUSTEE | Legal Service code 29 | — | $129K |
| R. MACARTHUR EIN 36-6069119 EMPLOYEE | Employee (plan) Service code 30 | — | $129K |
| B. AFFETTO EIN 36-6069119 EMPLOYEE | Employee (plan) Service code 30 | — | $128K |
| ELITE ADMINISTRATION | Other fees; Insurance brokerage commissions and fees Service code 53 | — | $121K |
| MED-CARE MANAGEMENT EIN 88-0429522 NONE | Claims processing Service code 12 | — | $102K |
| L. CRUZ EIN 36-6069119 EMPLOYEE | Employee (plan) Service code 30 | — | $60K |
| V. NAPLES EIN 36-6069119 EMPLOYEE | Employee (plan) Service code 30 | — | $55K |
| A. ELIZONDO EIN 36-6069119 30 | Other fees Service code 99 | — | $53K |
| DENTAL NETWORK OF AMERICA EIN 36-3339483 NONE | Claims processing Service code 12 | — | $51K |
| C. TOMINBERG EIN 36-6069119 TRUSTEE | Consulting (general); Trustee (individual) Service code 16 | — | $48K |
| G. YOUMANS EIN 36-6069119 TRUSTEE | Consulting (general); Trustee (individual) Service code 16 | — | $46K |
| P. SWEEZY EIN 36-6069119 EMPLOYEE | Employee (plan) Service code 30 | — | $42K |
| ASHER, GITTLER, & D'ALBA EIN 36-2786883 NONE | Legal Service code 29 | — | $39K |
| G. PEREZ EIN 36-6069119 EMPLOYEE | Employee (plan) Service code 30 | — | $35K |
| FOSTER AND FOSTER EIN 59-1921114 NONE | Actuarial Service code 11 | — | $30K |
| S. TOMINBERG EIN 36-6069119 EMPLOYEE | Employee (plan) Service code 30 | — | $30K |
| M. MOORE EIN 36-6069119 EMPLOYEE | Employee (plan) Service code 30 | — | $30K |
| V. OSIKA EIN 36-6069119 EMPLOYEE | Employee (plan) Service code 30 | — | $28K |
| NATIONAL INVESTMENT SERVICES EIN 80-0169636 NONE | Investment management Service code 28 | — | $22K |
| MR MICROCHIP EIN 59-3084068 NONE | Other fees Service code 99 | — | $20K |
| AMALGAMATED BANK EIN 36-0721895 NONE | Investment management Service code 28 | — | $16K |
| MARCO CONSULTING GROUP EIN 36-3555078 NONE | Trustee (individual) Service code 20 | — | $13K |
| COMERICA EIN 42-1741646 NONE | Shareholder servicing fees; Investment management; Other services; Other fees; Float revenue Service code 28 | — | $8K |
| SOMMERS AND FAHRENBACH EIN 36-1796440 NONE | Copying and duplicating Service code 36 | — | $7K |
| UNITED BUILDING MAINTENANCE EIN 36-3925503 NONE | Other fees Service code 99 | — | $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 | 5,507 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 5,507 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | VISION SERVICE PLAN | 5,494 | $1.2M |
| Life insurance(2 contracts) | DEARBORN NATIONAL LIFE INSURANCE COMPANY | 5,003 | $566K |
| Stop-loss / reinsurancereinsurance | GERBER LIFE INSURANCE | 4,220 | $2.6M |
| Other(2 contracts) | DEARBORN NATIONAL LIFE INSURANCE COMPANY | 5,003 | $566K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 5,494 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.