| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INT'L MIDWEST LIMITED | — | SUN LIFE INSURANCE COMPANY OF CANADA | $32K | — | $32K | 7.72% |
| COTTINGHAM & BUTLER3 Filed as: COTTINGHAM & BUTLER INS SRVCS INC | — | SUN LIFE INSURANCE COMPANY OF CANADA | $10K | — | $10K | 2.27% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | — | RELIASTAR LIFE INSURANCE COMPANY | $47K | $6K | $53K | 16.42% |
| COTTINGHAM & BUTLER3 Filed as: COTTINGHAM & BUTLER INSURANCE | SERVICES, INC. PO BOX 28 DUBUQUE, IA 520040028 | RELIASTAR LIFE INSURANCE COMPANY | $12K | $609 | $12K | 3.85% |
| EOI SERVICE COMPANY INC3 Filed as: EOI SERVICE COMPANY INC. | 3100 E MIRALOMA AVE STE 240 ANAHEIM, CA 92806 | RELIASTAR LIFE INSURANCE COMPANY | $8K | — | $8K | 2.45% |
| IBENEFIT COMMUNICATION LLC3 Filed as: IBENEFIT COMMUNICATION, LLC | 6230 FAIRVIEW RD STE 210 CHARLOTTE, NC 282103150 | RELIASTAR LIFE INSURANCE COMPANY | — | $1K | $1K | 0.37% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UMR, INC. EIN 39-1995276 CLAIMS PROCESSING | Claims processing Service code 12 | — | $347K |
| HUB INT'L MIDWEST LIMITED BROKER | Other commissions Service code 55 | 55 JACKSON BLVD STE 14B CHICAGO, IL 60604 | $54K |
| COTTINGHAM & BUTLER INS SRVCS INC BROKER | Other commissions Service code 55 | 800 MAIN ST DUBUQUE, IA 52001 | $16K |
| RXBENEFITS, INC. EIN 63-1157085 CLIAMS PROCESSING | Claims processing Service code 12 | — | $8K |
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 | 446 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 450 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | VISION SERVICE PLAN | 381 | $60K |
| Life insurance | RELIASTAR LIFE INSURANCE COMPANY | 637 | $322K |
| Long-term disability | RELIASTAR LIFE INSURANCE COMPANY | 637 | $322K |
| Stop-loss / reinsurancereinsurance | SUN LIFE INSURANCE COMPANY OF CANADA | 0 | $420K |
| Other | RELIASTAR LIFE INSURANCE COMPANY | 637 | $322K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 637 | — |
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.