| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| JAMES R NELLIGAN & ASSOCIATES LLC3 | 1060 BROADDWAY SUITE 400 ALBANY, NY 12204 | METROPOLITAN LIFE INSURANCE COMPANY | $11K | $2K | $13K | 5.69% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 55 E JACKSON BLVD CHICAGO, IL 606044466 | METROPOLITAN LIFE INSURANCE COMPANY | $5K | — | $5K | 2.35% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 16253 COLLECTION CENTER DRIVE 40 W MADISON 4TH FL BANK OF AMERICA CHICAGO, IL 606930162 | METROPOLITAN LIFE INSURANCE COMPANY | — | $4K | $4K | 1.88% |
| 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 | $5K | $3K | $7K | 12.31% |
| 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 | $3K | $2K | $5K | 12.52% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 55 E JACSON BLVD FL 14 CHICAGO, IL 606044466 | VISION SERVICE PLAN | $2K | — | $2K | 4.23% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 1411 OPUS PL STE 450 DOWNERS GROVE, IL 605151423 | VISION SERVICE PLAN | $1K | — | $1K | 3.01% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST LTD | EMPLOYEE BENEFITS DEPT 55 E JACKSON BLVD #14A CHICAGO, IL 60604 | FIRST UNUM LIFE INSURANCE COMPANY | $3K | $860 | $3K | 19.72% |
| 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 | $2K | $824 | $3K | 20.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LTD BROKER | Other commissions Service code 55 | 55 E JACKSON BLVD CHICAGO, IL 60604 | $76K |
| SPRING HEALTH EIN 81-2832914 CONTRACT ADMINISTRATOR | Contract Administrator; Claims processing Service code 12 | — | $34K |
| EMPLOYEE BENEFITS CORPORATION EIN 39-2044064 CLAIMS PROCESSING | Claims processing; Contract Administrator Service code 12 | — | $4K |
| BLUECROSS BLUESHIELD OF ILLINOIS EIN 36-1236610 CONTRACT ADMINISTRATOR | Claims processing; Contract Administrator Service code 12 | — | -$152K |
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 | 180 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 183 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 697 | $226K |
| Vision | VISION SERVICE PLAN | 186 | $37K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 180 | $38K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 177 | $59K |
| Other(3 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 180 | $71K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 697 | — |
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.