| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ELITE ADMINISTRATION3 Filed as: ELITE ADMINISTRATION & INSURANCE GR | 1211 W. 22ND STREET, SUITE 820 OAK BROOK, IL 60523 | THE UNION LABOR LIFE INSURANCE COMPANY | $20K | — | $20K | 4.00% |
| ELITE ADMINISTRATION3 Filed as: ELITE ADMINISTRATION & INSURANCE GR | 1211 W. 22ND STREET, SUITE 820 OAK BROOK, IL 60523 | DEARBORN NATIONAL LIFE INSURANCE COMPANY | $4K | $3K | $7K | 17.70% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD EIN 36-1236610 NONE | Claims processing; Other commissions Service code 12 | — | $148K |
| DOWD BLOCH BENNETT CERVONE AUERBACH EIN 36-3371377 NONE | Legal Service code 29 | — | $97K |
| PAYD HEALTH NONE | Other services Service code 49 | 4001 MCEWEN ROAD, STE 450 DALLAS, TX 75244 | $86K |
| EMPIRX HEALTH EIN 47-1226691 NONE | Claims processing Service code 12 | — | $43K |
| INVESTMENT CONSULTING SERVICES EIN 32-0016703 NONE | Investment advisory (plan); Consulting fees Service code 27 | — | $37K |
| TFBC, LLC EIN 27-3782504 NONE | Consulting (general); Actuarial Service code 11 | — | $36K |
| MACNELL ACCOUNTING AND CONSULTING EIN 30-0510353 NONE | Accounting (including auditing) Service code 10 | — | $34K |
| BUCK GLOBAL EIN 13-3954297 NONE | Other services Service code 49 | — | $31K |
| CALIBRE CPA GROUP, PLLC EIN 47-0900880 NONE | Accounting (including auditing) Service code 10 | — | $31K |
| BRIDGEWAY BENEFIT TECHNOLOGIES EIN 52-1796473 NONE | Other services Service code 49 | — | $19K |
| BAUM SIGMAN AUERBACH & NEUMAN, LTD. EIN 36-2744057 NONE | Legal Service code 29 | — | $19K |
| NATIONAL INVESTMENT SERVICES OF AME EIN 84-3937993 NONE | Investment management fees paid directly by plan Service code 51 | — | $16K |
| MEDCARE MANAGEMENT EIN 88-0429522 NONE | Other services Service code 49 | — | $12K |
| ADP NONE | Other services Service code 49 | 1 ADP BLVD ROSELAND, NJ 07068 | $10K |
| DELTA DENTAL EIN 36-2612058 NONE | Claims processing Service code 12 | — | $8K |
| BOND BROTHERS & CO. NONE | Other services Service code 49 | 7826 WEST 47TH STREET LYONS, IL 60534 | $8K |
| RED CARD SYSTEMS LLC EIN 20-5388701 NONE | Copying and duplicating Service code 36 | — | $8K |
| JOHNSON INVESTMENT COUNSEL NONE | Investment management fees paid directly by plan Service code 51 | 3777 WEST FORK ROAD CINCINNATI, OH 45247 | $7K |
| PREFERRED NETWORK ACCESS EIN 36-4018433 NONE | Other services Service code 49 | — | $7K |
| EMPLOYEE RESOURCE SYSTEMS NONE | Other services Service code 49 | 29 E MADISON ST. STE 1600 CHICAGO, IL 60602 | $7K |
| LASALLE CONSULTING PARTNERS INC. NONE | Consulting fees Service code 70 | 200 W MADISON ST STE 940 CHICAGO, IL 60606 | $7K |
| OLD NATIONAL BANK EIN 35-1539838 NONE | Account maintenance fees; Recordkeeping fees Service code 64 | — | $7K |
| CHC WELLBEING NONE | Other services Service code 49 | 5440 N CUMBERLAND AVENUE CHICAGO, IL 60656 | $6K |
| ELITE ADMINISTRATION INC. | Insurance brokerage commissions and fees Service code 53 | — | $2K |
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 | 403 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 405 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | DEARBORN NATIONAL LIFE INSURANCE COMPANY | 425 | $38K |
| Stop-loss / reinsurancereinsurance | THE UNION LABOR LIFE INSURANCE COMPANY | 429 | $500K |
| Other | DEARBORN NATIONAL LIFE INSURANCE COMPANY | 425 | $38K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 429 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.