| 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 | $213K | — | $213K | 1.78% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST LTD | 55 E JACKSON BLVD CHICAGO, IL 60604 | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | — | $4K | $4K | 2.64% |
| CENTRO BENEFITS RESEARCH LLC3 | 325 N KIRKWOOD ROAD SUITE 300 KIRKWOOD, MO 63122 | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $3K | — | $3K | 2.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | HUB INT'L MIDWEST INS ACY 55 E JACKSON BLVD 14TH FL CHICAGO, IL 60604 | HEALTH NET | $3K | — | $3K | 2.06% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST WEST | 55 E JACKSON BLVD. CHICAGO, IL 60604 | DELTA DENTAL OF ILLINOIS | $3K | — | $3K | 3.30% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE CO EIN 59-1031071 CONTRACT ADMINISTRATOR | Contract Administrator; Participant communication; Named fiduciary; Claims processing; Non-monetary compensation; Direct payment from the plan; Float revenue; Other services Service code 12 | — | $50K |
| CIGNA | Claims processing; Direct payment from the plan; Float revenue; Named fiduciary; Other services; Contract Administrator; Participant communication; Non-monetary compensation Service code 12 | — | $0 |
| CIGNA HEALTHY REWARDS VENDORS | Float revenue; Claims processing; Non-monetary compensation; Direct payment from the plan; Named fiduciary; Participant communication; Other services; Contract Administrator 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 | 1,375 | 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) | 1,375 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF ILLINOIS | 1,169 | $97K |
| Vision | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 109 | $450K |
| Life insurance | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 1,347 | $141K |
| Short-term disability | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 1,347 | $141K |
| Long-term disability | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 1,347 | $141K |
| Other | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 1,347 | $141K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,836 | — |
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.