| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST INS | 55 EAST JACKSON BLVD FLOOR 12 CHICAGO, IL 60604 | BLUE SHIELD OF CALIFORNIA LIFE & HEALTH INSURANCE COMPANY | $44K | — | $44K | 5.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | PO BOX 2167 GRAND RAPIDS, MI 49501 | SUN LIFE ASSURANCE COMPANY OF CANADA | $37K | $2K | $40K | 16.84% |
| CENTRO BENEFITS RESEARCH LLC3 | 325 N KIRKWOOD RD SUITE 300 KIRKWOOD, MO 63122 | SUN LIFE ASSURANCE COMPANY OF CANADA | $12K | — | $12K | 5.29% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST LTD | 3390 UNIVERSITY AVE., SUITE 300 RIVERSIDE, CA 92501 | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $34K | $2K | $36K | 70.21% |
| CENTRO BENEFITS RESEARCH LLC3 | 325 N KIRKWOOD ROAD SUITE 300 KIRKWOOD, MO 63122 | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $3K | — | $3K | 5.46% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 55 E JACKSON BLVD FL 14 CHICAGO, IL 606044466 | VISION SERVICE PLAN | $2K | — | $2K | 4.42% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 1411 OPUS PL STE 450 DOWNERS GROVE, IL 605151423 | VISION SERVICE PLAN | $1K | — | $1K | 3.26% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 3390 UNIVERSITY AVE, SUITE 300 RIVERSIDE, CA 92501 | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $2K | $165 | $2K | 38.04% |
| CENTRO BENEFITS RESEARCH LLC3 | 325 N KIRKWOOD RD SUITE 300 KIRKWOOD, MO 63122 | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $238 | — | $238 | 5.43% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HUB INTERNATIONAL MIDWEST INS EIN 35-0672425 BROKER | Insurance agents and brokers; Other commissions Service code 22 | 55 EAST JACKSON BLVD FLOOR 2 CHICAGO, IL 60604 | $6K |
| RXBENEFITS EIN 63-1157085 CLAIMS PROCESSING | Claims processing Service code 12 | — | $5K |
| FLORES AND ASSOCIATES EIN 56-1542307 CLAIMS PROCESSING | Claims processing Service code 12 | — | $4K |
| HUB INTERNATIONAL MIDWEST LIMITED BROKER | Insurance agents and brokers; Other commissions Service code 22 | PO BOX 2167 GRAND RAPIDS, MI 49501 | $165 |
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 | 357 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 23 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 380 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental(2 contracts) | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 324 | $55K |
| Vision | VISION SERVICE PLAN | 305 | $37K |
| Life insurance(2 contracts, 2 carriers) | BLUE SHIELD OF CALIFORNIA LIFE & HEALTH INSURANCE COMPANY | 425 | $1.1M |
| Short-term disability(2 contracts, 2 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 425 | $286K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 425 | $235K |
| Stop-loss / reinsurancereinsurance | BLUE SHIELD OF CALIFORNIA LIFE & HEALTH INSURANCE COMPANY | 357 | $882K |
| Other(2 contracts, 2 carriers) | BLUE SHIELD OF CALIFORNIA LIFE & HEALTH INSURANCE COMPANY | 425 | $1.1M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 425 | — |
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.