| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 | 55 E JACKSON BLVD CHICAGO, IL 60604 | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $165K | $67K | $232K | 12.98% |
| CENTRO BENEFITS RESEARCH LLC3 | 325 N KIRKWOOD ROAD SUITE 300 KIRKWOOD, MO 631224042 | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $33K | — | $33K | 1.85% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 55 E JACKSON BLVD CHICAGO, IL 606044466 | UNITEDHEALTHCARE INSURANCE COMPANY | $62K | — | $62K | 5.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 55 E JACKSON BLVD FL 14 CHICAGO, IL 606044466 | VISION SERVICE PLAN | $35K | — | $35K | 10.62% |
| GLOBAL BENEFITS INC3 Filed as: GLOBAL BENEFITS, INC. | 570 LAKE COOK RD STE 106 DEERFIELD, IL 600154910 | VISION SERVICE PLAN | -$9K | — | -$9K | -2.60% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 55 E JACKSON BLVD CHICAGO, IL 60604 | UNITEDHEALTHCARE CENTER INSURANCE COMPANY | $170K | — | $170K | 55.69% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UMR, INC. EIN 39-1995276 CLAIM PROCESSING | Claims processing Service code 12 | — | $1.5M |
| HUB INT'L MIDWEST LIMITED EIN 35-0672425 BROKER | Other commissions Service code 55 | ATTN ACCOUNTING 55 E JACKSON BLVD STE 14B CHICAGO, IL 60604 | $392K |
| OPTUMRX, INC. EIN 33-0441200 PHARMACY BENEFIT MGMT | Other fees; Float revenue; Direct payment from the plan; Claims processing Service code 12 | — | $260K |
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 | 2,285 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 26 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 2,311 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental(2 contracts, 2 carriers) | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 4,753 | $3.0M |
| Vision | VISION SERVICE PLAN | 2,357 | $327K |
| Life insurance | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 2,285 | $1.8M |
| Short-term disability | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 2,285 | $1.8M |
| Long-term disability | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 2,285 | $1.8M |
| Prescription drug | RXBENEFITS, INC. | 1,707 | $5.7M |
| Stop-loss / reinsurancereinsurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 1,670 | $1.2M |
| Other(2 contracts, 2 carriers) | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 2,285 | $2.1M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 4,753 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.