| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 | 3390 UNIVERSITY AVENUE, SUITE 300 RIVERSIDE, CA 92501 | GUARDIAN | $51K | $0 | $51K | 10.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 55 E JACKSON BLVD FL 14 CHICAGO, IL 60604 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $10K | $0 | $10K | 15.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 55 E. JACKSON BLVD, 14TH FLOOR CHICAGO, IL 60604 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $9K | $0 | $9K | 15.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 55 E JACKSON BLVD FL 14 CHICAGO, IL 60604 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $6K | $0 | $6K | 15.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 1411 OPUS PLACE STE 450 DOWNERS GROVE, IL 60515 | VSP VISION CARE FOR LIFE | $1K | $0 | $1K | 2.68% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 55 E JACKSON BLVD FL 14 CHICAGO, IL 60604 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $2K | $0 | $2K | 15.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 55 E JACKSON BLVD FL 14 CHICAGO, IL 60604 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $61 | $0 | $61 | 15.06% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 55 E JACKSON BLVD FL 14 CHICAGO, IL 606044466 | METROPOLITAN LIFE INSURANCE COMPANY | $9K | $45 | $10K | — |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 16253 COLLECTION CENTER DR. CHICAGO, IL 606930162 | METROPOLITAN LIFE INSURANCE COMPANY | — | $1K | $1K | — |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF ILLINOIS EIN 36-1236610 NONE | Claims processing Service code 12 | — | $3.7M |
| BUTLER HEALTHCORP, INC. EIN 42-1403200 NONE | Other services Service code 49 | — | $523K |
| GROUP ADMINISTRATORS, LTD. EIN 36-3381052 NONE | Contract Administrator; Claims processing Service code 12 | — | $63K |
| COMPSYCH CORPORATION EIN 36-3739783 NONE | Other services Service code 49 | — | $21K |
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 | 356 | Currently employed and enrolled or eligible. |
| Retired/separated still eligible | 3 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 359 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF ILLINOIS | 184 | $1.2M |
| Dental(2 contracts, 2 carriers) | GUARDIAN | 362 | $510K |
| Vision | VSP VISION CARE FOR LIFE | 367 | $39K |
| Life insurance | DEARBORN LIFE INSURANCE COMPANY | 360 | $93K |
| Short-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 328 | $70K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 303 | $63K |
| Other(4 contracts) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 56 | $55K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 367 | — |
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."
No prospect flags tripped on this filing.