| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 | 55 E JACKSON BLVD FLOOR 14A CHICAGO, IL 60604 | BLUECROSS BLUESHIELD OF ILLINOIS | $181K | $3K | $184K | 4.06% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | PO BOX 2167 GRAND RAPIDS, MI 49501 | SUN LIFE ASSURANCE COMPANY OF CANADA | $67K | — | $67K | 20.13% |
| JAMES R NELLIGAN & ASSOCIATES LLC3 | 1933 STATE ROUTE 35 STE 368 WALL, NJ 07719 | SUN LIFE ASSURANCE COMPANY OF CANADA | $17K | — | $17K | 5.03% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | EMPLOYEE BENEFITS DEPT 55 E JACKSON BLVD #14A CHICAGO, IL 60604 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $9K | — | $9K | 20.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST WEST | PO BOX 2167 GRAND RAPIDS, MI 49501 | DELTA DENTAL OF ILLINOIS | $16K | — | $16K | 44.91% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 55 E JACKSON BLVD FL 14 CHICAGO, IL 606044466 | VISION SERVICE PLAN | $2K | — | $2K | 8.69% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| SUN LIFE ASSURANCE OF CANADA EIN 38-1082080 CLAIMS PROCESSING | Claims processing Service code 12 | — | $23K |
| HUB INTERNTIONAL MIDWEST LIMITED BROKER | Other commissions; Insurance agents and brokers Service code 22 | PO BOX 2167 GRAND RAPIDS, MI 49501 | $10K |
| EMPLOYEE BENEFITS CORPORATION EIN 39-2044064 CLAIMS PROCESSING | Contract Administrator; Claims processing Service code 12 | — | $5K |
| JAMES R NELLIGAN & ASSOCIATES LLC BROKER | Insurance agents and brokers; Other commissions Service code 22 | 1933 STATE ROUTE 35 SUITE 368 WALL, NJ 07719 | $1K |
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 | 310 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 310 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUESHIELD OF ILLINOIS | 620 | $4.5M |
| Dental | DELTA DENTAL OF ILLINOIS | 251 | $35K |
| Vision | VISION SERVICE PLAN | 208 | $26K |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 310 | $334K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 310 | $334K |
| Other(2 contracts, 2 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 310 | $377K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 620 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.