| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 | 55 E JACKSON BLVD CHICAGO, IL 60604 | UNITEDHEALTHCARE INSURANCE COMPANY | — | $100K | $100K | 5.26% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | ATTN EMPLOYEE BENEFITS DEPT 55 E JACKSON BLVD #14A CHICAGO, IL 60604 | RELIASTAR LIFE INSURANCE COMPANY | $41K | — | $41K | 15.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | ATTN EMPLOYEE BENEFITS DEPT 55 E JACKSON BLVD #14A CHICAGO, IL 60604 | RELIASTAR LIFE INSURANCE COMPANY | — | $11K | $11K | 4.19% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| GROUP ADMINISTRATORS, LTD. NONE | Claims processing Service code 12 | 915 NATIONAL PARKWAY SUITE F SCHAUMBURG, IL 60173 | $166K |
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 | 591 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 33 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 624 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | UNITEDHEALTHCARE INSURANCE COMPANY | 382 | $2.4M |
| Vision | VISION SERVICE PLAN | 560 | $82K |
| Life insurance | RELIASTAR LIFE INSURANCE COMPANY | 980 | $271K |
| Long-term disability | RELIASTAR LIFE INSURANCE COMPANY | 980 | $271K |
| Other | RELIASTAR LIFE INSURANCE COMPANY | 980 | $271K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 980 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.