| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | 1255 BATTERY STREET, SUITE 450 SAN FRANCISCO, CA 94111 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $451K | — | $451K | 3.71% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST LTD | 55 E JACKSON BLVD CHICAGO, IL 60604 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $186K | — | $186K | 1.53% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2 PIERCE PL ITASCA, IL 60143 | KAISER FOUNDATION HEALTH PLAN INC. | $81K | — | $81K | 2.81% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 55 E JACKSON BLVD CHICAGO, IL 60604 | KAISER FOUNDATION HEALTH PLAN INC. | $60K | — | $60K | 2.08% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2 PIERCE PL 14TH FLR ITASCA, ID 60143 | KAISER FOUNDATION HEALTH PLAN INC. | — | $3K | $3K | 0.10% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2 PIERCE PL ITASCA, IL 60143 | KAISER FOUNDATION HEALTH PLAN INC. | $59K | — | $59K | 3.12% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 55 E JACKSON BLVD CHICAGO, IL 60604 | KAISER FOUNDATION HEALTH PLAN INC. | $40K | — | $40K | 2.10% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2 PIERCE PL 14TH FLR ITASCA, ID 60143 | KAISER FOUNDATION HEALTH PLAN INC. | — | $2K | $2K | 0.11% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2 PIERCE PL FL 21 ITASCA, IL 60143 | PRINCIPAL LIFE INSURANCE COMPANY | — | $29K | $29K | 4.17% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2 PIERCE PL FL 14 ITASCA, IL 60143 | PRINCIPAL LIFE INSURANCE COMPANY | $26K | — | $26K | 3.67% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 55 E JACKSON BLVD CHICAGO, IL 60604 | PRINCIPAL LIFE INSURANCE COMPANY | $25K | — | $25K | 3.52% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 15162 COLLECTION CENTER DR CHICAGO, IL 60693 | VISION SERVICE PLAN | $3K | — | $3K | 1.46% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 2 PIERCE PL FL 14 ITASCA, IL 60143 | VISION SERVICE PLAN | $3K | — | $3K | 1.43% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE CO. EIN 59-1031071 CLAIMS ADMINISTRATOR | Other services; Direct payment from the plan; Contract Administrator; Participant communication; Float revenue; Named fiduciary; Non-monetary compensation; Claims processing Service code 12 | — | $11K |
| CIGNA | Named fiduciary; Other services; Contract Administrator; Participant communication; Float revenue; Non-monetary compensation; Direct payment from the plan; Claims processing Service code 12 | — | $0 |
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 | 3,594 | 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) | 3,594 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 3 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 2,853 | $17.5M |
| Dental(2 contracts, 2 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 3,594 | $1.2M |
| Vision | VISION SERVICE PLAN | 2,154 | $208K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 3,594 | $704K |
| Short-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 3,594 | $704K |
| Long-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 3,594 | $704K |
| Prescription drug | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 2,853 | $12.2M |
| Other | CLAREMONT | 3,000 | $54K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 3,594 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.