| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ELITE ADMINISTRATION3 Filed as: ELITE ADMINISTRATION & INSUR. GROUP | 1211 W. 22ND STREET STE 820 OAK BROOK, IL 60523 | THE UNION LABOR LIFE INSURANCE COMPANY | $70K | — | $70K | 9.00% |
| ELITE ADMINISTRATION3 Filed as: ELITE ADMINISTRATION &INS GROUP INC | 1211 W 22ND ST STE 820 OAKBROOK, IL 60523 | DEARBORN NATIONAL LIFE INSURANCE COMPANY | $11K | $7K | $18K | 16.82% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF ILLINOIS EIN 36-1236610 NONE | Contract Administrator; Other fees Service code 13 | — | $1.8M |
| ELITE ADMIN & INSURANCE GROUP, INC EIN 36-2238689 NONE | Other fees; Claims processing; Other services; Contract Administrator Service code 12 | — | $586K |
| ROSE FOLLENWEIDER EIN 36-6198426 ADMINISTRATOR | Employee (plan) Service code 30 | — | $174K |
| DELTA DENTAL EIN 36-2612058 NONE | Contract Administrator; Other fees Service code 13 | — | $121K |
| MED-CARE MANAGEMENT INC. EIN 88-0429522 NONE | Other fees Service code 99 | — | $113K |
| VERONICA MISTER EIN 36-6198426 EMPLOYEE | Employee (plan) Service code 30 | — | $97K |
| CLAUDIA ERAZO EIN 36-6198426 EMPLOYEE | Employee (plan) Service code 30 | — | $81K |
| SHEILA TAYLOR EIN 36-6198426 EMPLOYEE | Employee (plan) Service code 30 | — | $79K |
| MESIROW FINANCIAL EIN 36-3429599 NONE | Investment management Service code 28 | — | $66K |
| BANSLEY AND KIENER, LLP EIN 36-2152389 NONE | Accounting (including auditing) Service code 10 | — | $61K |
| I.U.O.E. LOCAL 399 EIN 36-1265730 AFFILIATED ORGANIZATION | Other fees Service code 99 | — | $48K |
| VISION SERVICE PLAN ILLINOIS EIN 20-0891619 NONE | Contract Administrator; Other fees Service code 13 | — | $47K |
| GLOBALCARE INC. EIN 31-1407689 NONE | Other fees Service code 99 | — | $39K |
| AON HEWITT INVESTMENT CONSULT. INC. EIN 36-3109431 NONE | Investment advisory (plan) Service code 27 | — | $25K |
| CARMELL CHARONE WIDMER MOSS & BARR EIN 36-2738528 NONE | Legal Service code 29 | — | $25K |
| FOSTER AND FOSTER EIN 59-1921114 NONE | Actuarial; Consulting (general) Service code 11 | — | $25K |
| LAYER 7 SYSTEMS, LLC EIN 26-1638894 NONE | Consulting (general) Service code 16 | — | $11K |
| JAYSTAR GROUP, INC. EIN 56-2299776 NONE | Consulting (general) Service code 16 | — | $10K |
| AMALGATRUST EIN 36-0721895 NONE | Account maintenance fees; Float revenue Service code 62 | — | $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 | 4,072 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 57 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 4,129 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | DEARBORN NATIONAL LIFE INSURANCE COMPANY | 4,033 | $106K |
| Stop-loss / reinsurancereinsurance | THE UNION LABOR LIFE INSURANCE COMPANY | 4,072 | $775K |
| Other | DEARBORN NATIONAL LIFE INSURANCE COMPANY | 4,033 | $106K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 4,072 | — |
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.