| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 55 E JACKSON BLVD FL 14 CHICAGO, IL 606044466 | METROPOLITAN LIFE INSURANCE COMPANY | $11K | $47 | $11K | 4.16% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 16253 COLLECTION CENTER DR 40 W MADISON 4TH FL BANK OF AMERICA CHICAGO, IL 606930162 | METROPOLITAN LIFE INSURANCE COMPANY | — | $1K | $1K | 0.52% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 55 E JACKSON BLVD FL 14 CHICAGO, IL 606044466 | METROPOLITAN LIFE INSURANCE COMPANY | $6K | $47 | $6K | 13.12% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 16253 COLLECTION CENTER DR 40 W MADISON 4TH FL BANK OF AMERICA CHICAGO, IL 606930162 | METROPOLITAN LIFE INSURANCE COMPANY | — | $470 | $470 | 1.09% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 55 E JACKSON BLVD FL 14 CHICAGO, IL 606044466 | METROPOLITAN LIFE INSURANCE COMPANY | $3K | $47 | $3K | 13.34% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 16253 COLLECTION CENTER DR 40 W MADISON 4TH FL BANK OF AMERICA CHICAGO, IL 606930162 | METROPOLITAN LIFE INSURANCE COMPANY | — | $228 | $228 | 1.09% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UMR. INC. EIN 39-1995276 CLAIMS PROCESSING | Claims processing Service code 12 | — | $382K |
| HUB INTERNATIONAL MIDWEST LIMITED BROKER | Other commissions Service code 55 | 55 E JACKSON BLVD STE 14B ATTN ACCOUNTING CHICAGO, IL 60604 | $90K |
| RXBENEFITS, INC. EIN 63-1157085 CLAIMS PROCESSING | Claims processing Service code 12 | — | $4K |
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 | 454 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 11 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 465 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF COLORADO | 913 | $386K |
| Vision | VISION SERVICE PLAN | 389 | $69K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 639 | $273K |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 639 | $273K |
| Stop-loss / reinsurancereinsurance | QBE INSURANCE CORPORATION | 404 | $1.4M |
| Other(3 contracts) | METROPOLITAN LIFE INSURANCE COMPANY | 639 | $337K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 913 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.