| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 | 2120 PEWAUKEE RD SUITE 202 WAUKESHA, WI 53188 | HEALTHY ALLIANCE LIFE INSURANCE COMPANY | $29K | — | $29K | 1.41% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SERVICES INC | 3390 UNIVERSITY AVE., SUITE 300 RIVERSIDE, CA 92501 | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $6K | $3K | $9K | 14.52% |
| JAMES R NELLIGAN & ASSOCIATES LLC3 Filed as: JAMES R NELLIGAN & ASSOCIATES | 1060 BROADWAY SUITE 400 ALBANY, NY 12204 | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $3K | — | $3K | 5.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | PO BOX 2158 RIVERSIDE, CA 92516 | VISION SERVICE PLAN | $3K | — | $3K | 10.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 125 S WACKER DR STE 300 CHICAGO, IL 60606 | ANTHEM LIFE INSURANCE COMPANY | $1K | — | $1K | 4.66% |
No Schedule C service providers reported on this filing.
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 | 220 | 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) | 220 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HEALTHY ALLIANCE LIFE INSURANCE COMPANY | 408 | $2.0M |
| Dental | HEALTHY ALLIANCE LIFE INSURANCE COMPANY | 408 | $2.0M |
| Vision | VISION SERVICE PLAN | 148 | $26K |
| Life insurance | ANTHEM LIFE INSURANCE COMPANY | 220 | $25K |
| Short-term disability | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 216 | $61K |
| Long-term disability | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 216 | $61K |
| Other | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 216 | $61K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 408 | — |
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.