| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST LTD | 55 E JACKSON BLVD 14TH FL CHICAGO, IL 60604 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $0 | $82K | $82K | 5.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 55 E JACKSON BLVD FL 14 CHICAGO, IL 606044466 | METROPOLITAN LIFE INSURANCE COMPANY | $15K | $54 | $15K | 9.91% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 40 W MADISON 4TH FL BANK OF AMERICA 16253 COLLECTIONS CENTER DR CHICAGO, IL 606930162 | METROPOLITAN LIFE INSURANCE COMPANY | — | $2K | $2K | 1.25% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST | 15162 COLLECTIONS CENTER CHICAGO, IL 60693 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | — | $3K | 4.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST | 15162 COLLECTIONS CENTER CHICAGO, IL 60693 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | — | $1K | 4.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST | 15162 COLLECTIONS CENTER CHICAGO, IL 60693 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | — | $1K | 4.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST | 15162 COLLECTIONS CENTER CHICAGO, IL 60693 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $182 | — | $182 | 4.01% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST LTD | 55 E JACKSON BLVD 14TH FL STE 14A CHICAGO, IL 60604 | CIGNA LIFE INSURANCE CO. OF NEW YORK | $111 | — | $111 | 10.01% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE CO EIN 59-1031071 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | — | $82K |
| SURENCY LIFE & HEALTH INSURANCE EIN 26-1969006 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | — | $4K |
| HUB INTERNATIONAL MIDWEST LIMITED BROKER | Insurance agents and brokers; Other commissions Service code 22 | 55 E JACKSON BLVD CHICAGO, IL 60604 | $3K |
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 | 183 | 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) | 183 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 276 | $1.6M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 523 | $153K |
| Vision | VISION SERVICE PLAN | 137 | $26K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 416 | $28K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 198 | $63K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 198 | $28K |
| Other(3 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 416 | $33K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 523 | — |
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.