| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 | 55 E JACKSON BLVD CHICAGO, IL 60604 | KAISER FOUNDATION HEALTH PLAN INC | $207K | — | $207K | 1.80% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | HUB INT'L MIDWEST INS ACY 55 E JACKSON BLVD 14TH FL CHICAGO, IL 60604 | HEALTH NET | $4K | — | $4K | 1.42% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST LTD | 55 E JACKSON BLVD CHICAGO, IL 60604 | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $2K | $8K | $10K | 6.76% |
| CENTRO BENEFITS RESEARCH LLC3 Filed as: CENTRO BENEFITS GROUP | 325 N KIRKWOOD ROAD SUITE 300 KIRKWOOD, MO 63122 | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $3K | — | $3K | 2.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST WEST | 55 E JACKSON BLVD. CHICAGO, IL 60604 | DELTA DENTAL OF ILLINOIS | $4K | — | $4K | 3.46% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE CO EIN 59-1031071 CLAIMS ADMINISTRATOR | Float revenue; Contract Administrator; Named fiduciary; Direct payment from the plan; Claims processing; Non-monetary compensation; Other services; Participant communication Service code 12 | — | $53K |
| CIGNA | Other services; Non-monetary compensation; Claims processing; Participant communication; Direct payment from the plan; Named fiduciary; Contract Administrator; Float revenue Service code 12 | — | $0 |
| CIGNA HEALTHY REWARDS VENDORS | Participant communication; Direct payment from the plan; Non-monetary compensation; Claims processing; Contract Administrator; Other services; Float revenue; Named fiduciary Service code 12 | — | $0 |
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 | 1,414 | 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) | 1,414 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF ILLINOIS | 1,227 | $125K |
| Vision | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 120 | $404K |
| Life insurance | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 1,414 | $146K |
| Short-term disability | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 1,414 | $146K |
| Long-term disability | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 1,414 | $146K |
| Other | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 1,414 | $146K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,850 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.