| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 | PO BOX 2158 RIVERSIDE, CA 92516 | SUN LIFE ASSURANCE COMPANY OF CANADA | — | $22K | $22K | 5.10% |
| SBR SERVICES LLC3 | 2300 WINDY RIDGE PKWY SE SUITE 6955 ATLANTA, GA 30339 | SUN LIFE ASSURANCE COMPANY OF CANADA | — | $22K | $22K | 5.03% |
| UMR, INC.3 | 115 W WAUSAW AVE WAUSAU, WI 54401 | SUN LIFE ASSURANCE COMPANY OF CANADA | — | $3K | $3K | 0.58% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | ATTN EMPLOYEE BENEFITS DEPT 55 E JACKSON BLVD #14A CHICAGO, IL 60604 | RELIASTAR LIFE INSURANCE COMPANY | $43K | $14K | $58K | 17.61% |
| EOI SERVICE COMPANY INC3 Filed as: EOI SERVICE COMPANY INC. | 1820 E FIRST ST STE 400 SANTA ANA, CA 92705 | RELIASTAR LIFE INSURANCE COMPANY | $8K | $2K | $9K | 2.85% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | ATTN EMPLOYEE BENEFITS DEPT 55 E JACKSON BLVD #14A CHICAGO, IL 60604 | RELIASTAR LIFE INSURANCE COMPANY | — | $8K | $8K | 2.40% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 1411 OPUS PL STE 450 DOWNERS GROVE, IL 605151423 | VISION SERVICE PLAN | $169 | — | $169 | 0.25% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UMR, INC. EIN 39-1995276 CLAIMS PROCESSING | Claims processing Service code 12 | — | $479K |
| HUB INTERNATIONAL MIDWEST LTD EIN 35-0672425 BROKER | Other commissions Service code 55 | ATTN ACCOUNTING 55 E JACKSON BLVD STE 14B CHICAGO, IL 60604 | $81K |
| PERSPECTIVES LTD EIN 36-3444982 NONE | Contract Administrator; Claims processing Service code 12 | — | $14K |
| RXBENEFITS, INC. EIN 63-1157085 CLAIMS 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 | 550 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 13 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 563 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | VISION SERVICE PLAN | 465 | $68K |
| Life insurance | RELIASTAR LIFE INSURANCE COMPANY | 768 | $327K |
| Long-term disability | RELIASTAR LIFE INSURANCE COMPANY | 768 | $327K |
| Stop-loss / reinsurancereinsurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 502 | $433K |
| Other | RELIASTAR LIFE INSURANCE COMPANY | 768 | $327K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 768 | — |
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.