| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 | 203 N LA SALLE STREET, 20TH FLOOR CHICAGO, IL 60601 | BLUECROSS BLUESHIELD OF ILLINOIS | $54K | — | $54K | 2.22% |
| ASSUREDPARTNERS3 Filed as: ASSUREDPARTNERS OF ILLINOIS, LLC | 25 NW POINT BOULEVARD, SUITE 625 ELK GROVE VILLAGE, IL 60007 | BLUECROSS BLUESHIELD OF ILLINOIS | $40K | $3K | $43K | 1.75% |
| ASSUREDPARTNERS3 Filed as: ASSUREDPARTNERS OF ILLINOIS, LLC | 25 NW POINT BOULEVARD, SUITE 625 ELK GROVE VILLAGE, IL 600071033 | KAISER FOUNDATION HEALTH PLAN, INC. | $2K | — | $2K | 1.59% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 55 E JACKSON BLVD CHICAGO, IL 606044466 | KAISER FOUNDATION HEALTH PLAN, INC. | $2K | — | $2K | 1.53% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST | 1591 GALBRAITH AVE S GRAND RAPIDS, MI 49546 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $8K | — | $8K | 12.90% |
| CRAWFORD ADVISORS, LLC3 Filed as: CRAWFORD ADVISORS LLC | 10 NORTH PARK DRIVE SUITE 200 HUNT VALLEY, MD 210301827 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $6K | — | $6K | 9.30% |
| ASSUREDPARTNERS3 Filed as: ASSUREDPARTNERS OF ILLINOIS, LLC | FOUR WESTBROOK CORPORATE CENTER SUITE 500 WESTCHESTER, IL 60154 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $5K | — | $5K | 8.87% |
| IMG3 | 2960 NORTH MERIDIAN STREET INDIANAPOLIS, IN 46208 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $31 | $31 | 0.05% |
| ASSUREDPARTNERS3 Filed as: ASSUREDPARTNERS OF IL LLC | 4350 WEAVER PARKWAY WARRENVILLE, IL 60555 | EYEMED VISION CARE | $2K | — | $2K | 14.51% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | PO BOX 2167 GRAND RAPIDS, MI 49501 | EYEMED VISION CARE | $2K | — | $2K | 14.51% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST LTD | 3390 UNIVERSITY AVE., SUITE 300 RIVERSIDE, CA 92501 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $3K | — | $3K | 22.33% |
| ASSUREDPARTNERS3 Filed as: ASSUREDPARTNERS OF ILLINOIS LLC | PO BOX 2830 1811 HIGH GROVE STE 139 NAPERVILLE, IL 60567 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $2K | $201 | $2K | 17.40% |
| ASSUREDPARTNERS3 Filed as: ASSUREDPARTNERS OF ILLINOIS | 4350 WEAVER PARKWAY WARRENVILLE, IL 60555 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $961 | — | $961 | 15.89% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST LTD | EMPLOYEE BENEFITS DEPT. 55 E JACKSON BLVD #14A CHICAGO, IL 60604 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $425 | $35 | $460 | 7.61% |
| SMITH, THOMAS, CHRISTOPHER3 | PO BOX 40386 798 BERRY RD NASHVILLE, TN 37204 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $28 | $1 | $29 | 0.48% |
| BROWN & BROWN INSURANCE SERVICES3 Filed as: BROWN & BROWN INS SERVICES INC | PO BOX 749140 ATLANTA, GA 30374 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $2 | $2 | 0.03% |
No Schedule C service providers reported on this filing.
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 | 179 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 9 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 188 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUECROSS BLUESHIELD OF ILLINOIS | 256 | $2.6M |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 134 | $13K |
| Vision | EYEMED VISION CARE | 296 | $13K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 147 | $59K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 146 | $44K |
| Other(5 contracts, 2 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 141 | $32K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 296 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.