| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ELITE ADMINISTRATION3 Filed as: ELITE ADMINISTRATION & INS GRP INC | 1211 W 22ND STREET, SUITE 820 OAK BROOK, IL 605233223 | DEARBORN NATIONAL LIFE INSURANCE COMPANY | $881 | $0 | $881 | 12.08% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| DMC INSURANCE ADMINISTRATORS EIN 94-3115552 NONE | Direct payment from the plan; Contract Administrator Service code 13 | — | $210K |
| SALTZMAN & JOHNSON EIN 94-2376174 NONE | Legal; Direct payment from the plan Service code 29 | — | $43K |
| LINDQUIST LLP EIN 52-2385296 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $42K |
| MILLIMAN USA EIN 91-0675641 NONE | Direct payment from the plan; Actuarial; Consulting (general) Service code 11 | — | $37K |
| UNITED CONCORDIA EIN 25-1687586 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $20K |
| INVESCO INSTITUTION EIN 58-1707262 NONE | Investment management; Investment management fees paid indirectly by plan Service code 28 | — | $13K |
| TEAMSTERS ASSISTANCE PROGRAM EIN 68-0048516 NONE | Other services; Direct payment from the plan Service code 49 | — | $11K |
| LARRY MORRISON EIN 94-6102389 TRUSTEE | Direct payment from the plan; Trustee (individual); Named fiduciary Service code 20 | — | $10K |
| TIM BREKKE EIN 94-6102389 TRUSTEE | Trustee (individual); Named fiduciary; Direct payment from the plan Service code 20 | — | $9K |
| JAMES BEARD EIN 94-6102389 TRUSTEE | Direct payment from the plan; Trustee (individual); Named fiduciary Service code 20 | — | $8K |
| THOMAS DILLON EIN 94-6102389 TRUSTEE | Trustee (individual); Named fiduciary; Direct payment from the plan Service code 20 | — | $7K |
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 | 627 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 10 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 637 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | VISION SERVICE PLAN | 601 | $54K |
| Life insurance(2 contracts, 2 carriers) | DEARBORN NATIONAL LIFE INSURANCE COMPANY | 334 | $13K |
| Other(4 contracts, 3 carriers) | LANDMARK HEALTHPLAN | 384 | $23K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,368 | — |
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 comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.