| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ELITE ADMINISTRATION3 Filed as: ELITE ADMINISTRATION & INSURANCE GR | 1211 W 22ND ST, SUITE 820 OAK BROOK, IL 60523 | THE UNION LABOR LIFE INSURANCE COMPANY | $29K | — | $29K | 6.36% |
| ELITE ADMINISTRATION3 Filed as: ELITE ADMINISTRATION & INSURANCE GR | 1211 W 22ND ST, SUITE 820 OAK BROOK, IL 60523 | DEARBORN NATIONAL LIFE INSURANCE COMPANY | $5K | $2K | $7K | 15.13% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD EIN 36-1236610 NONE | Claims processing; Other commissions Service code 12 | — | $364K |
| CLARSON, RICHARD EIN 36-6073848 EMPLOYEE | Plan Administrator Service code 14 | — | $171K |
| LACEY, RYAN EIN 36-6073848 EMPLOYEE | Employee (plan) Service code 30 | — | $127K |
| BOCCONCELLI, PATRICIA EIN 36-6073848 EMPLOYEE | Employee (plan) Service code 30 | — | $114K |
| PERNA, CINDY EIN 36-6073848 EMPLOYEE | Employee (plan) Service code 30 | — | $106K |
| GONZALEZ, THERISA EIN 36-6073848 EMPLOYEE | Employee (plan) Service code 30 | — | $95K |
| HUFFMAN, RONALD EIN 36-6073848 EMPLOYEE | Employee (plan) Service code 30 | — | $77K |
| NIMMER, SHEILA EIN 36-6073848 EMPLOYEE | Employee (plan) Service code 30 | — | $66K |
| MARSICK, DEBRA EIN 36-6073848 EMPLOYEE | Employee (plan) Service code 30 | — | $61K |
| BENSON, ALICIA EIN 36-6073848 EMPLOYEE | Employee (plan) Service code 30 | — | $60K |
| BUDESELICH, RITA EIN 36-6073848 EMPLOYEE | Employee (plan) Service code 30 | — | $56K |
| SAENZ, JOANNE EIN 36-6073848 EMPLOYEE | Employee (plan) Service code 30 | — | $55K |
| MCCARTHY, CONNIE EIN 36-6073848 EMPLOYEE | Employee (plan) Service code 30 | — | $53K |
| RAMIREZ, MARISOL EIN 36-6073848 EMPLOYEE | Employee (plan) Service code 30 | — | $51K |
| HAWRYSIO, SUSAN EIN 36-6073848 EMPLOYEE | Employee (plan) Service code 30 | — | $47K |
| HEALTH MANAGEMENT CONCEPTS, INC EIN 75-3189468 NONE | Other services Service code 49 | — | $44K |
| WEAVER, BONNIE EIN 36-6073848 EMPLOYEE | Employee (plan) Service code 30 | — | $40K |
| CORREA, VERONICA EIN 36-6073848 EMPLOYEE | Employee (plan) Service code 30 | — | $38K |
| INVESTMENT CONSULTING SERVICES EIN 32-0016703 NONE | Investment advisory (plan); Consulting fees Service code 27 | — | $37K |
| TFBC, LLC EIN 27-3782504 NONE | Consulting (general) Service code 16 | — | $35K |
| C.S. MCKEE, L.P. EIN 25-1900687 NONE | Investment management fees paid directly by plan; Investment management Service code 28 | — | $33K |
| DOWD BLOCH BENNETT CERVONE AUERBACH EIN 36-3371377 NONE | Legal Service code 29 | — | $26K |
| CALIBRE CPA GROUP, PLLC EIN 47-0900880 NONE | Accounting (including auditing) Service code 10 | — | $24K |
| MEDCARE MANAGEMENT EIN 88-0429522 NONE | Consulting (general) Service code 16 | — | $24K |
| BAUM SIGMAN AUERBACH & NEUMAN, LTD. EIN 36-2744057 NONE | Legal Service code 29 | — | $23K |
| DELTA DENTAL EIN 36-2612058 NONE | Claims processing Service code 12 | — | $18K |
| INNOVATIVE SOFTWARE SOLUTIONS EIN 23-2182079 NONE | Consulting (general) Service code 16 | — | $18K |
| MACNELL ACCOUNTING AND CONSULTING NONE | Accounting (including auditing) Service code 10 | 9436 SPRINGFIELD AVE. EVANSTON, IL 60203 | $17K |
| PREFERRED NETWORK ACCESS NONE | Other services Service code 49 | 1510 75TH ST DARIEN, IL 60561 | $13K |
| EMDEON PRINTING EIN 20-5591816 NONE | Copying and duplicating Service code 36 | — | $10K |
| EMPLOYEE RESOURCE SYSTEMS NONE | Other services Service code 49 | 29 E MADISON ST. STE 1600 CHICAGO, IL 60602 | $10K |
| INTERACTIVE HEALTH SOLUTIONS EIN 36-3798756 NONE | Other services Service code 49 | — | $10K |
| BOND BROTHERS EIN 36-2433269 NONE | Copying and duplicating Service code 36 | — | $8K |
| BARING INTERNATIONAL EIN 98-0241935 NONE | Investment management fees paid directly by plan; Investment management Service code 28 | — | $7K |
| CATAMARAN EIN 11-2581812 NONE | Claims processing Service code 12 | 1600 MCCONNOR PKWY SCHAUMBURG, IL 60173 | $6K |
| VISION SERVICE PLAN EIN 20-0891619 NONE | Contract Administrator; Claims processing Service code 12 | — | $5K |
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 | 606 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 8 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 614 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | DEARBORN NATIONAL LIFE INSURANCE COMPANY | 565 | $45K |
| Stop-loss / reinsurancereinsurance | THE UNION LABOR LIFE INSURANCE COMPANY | 608 | $452K |
| Other | DEARBORN NATIONAL LIFE INSURANCE COMPANY | 565 | $45K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 608 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.