| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 | 55 E JACKSON BLVD. CHICAGO, IL 60604 | BLUECROSS BLUESHIELD OF ILLINOIS | $42K | $1K | $43K | 4.35% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 55 E JACKSON BLVD. FLOOR 12 CHICAGO, IL 60604 | NATIONWIDE | $29K | — | $29K | 8.50% |
| FRINGE INSURANCE BENEFITS, INC.3 | 11910 ANDERSON MILL ROAD AUSTIN, TX 78726 | NATIONWIDE | $13K | — | $13K | 3.92% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 55 E JACKSON BLVD. FLOOR 12 CHICAGO, IL 60604 | AMERITAS | $13K | — | $13K | 10.00% |
| FRINGE INSURANCE BENEFITS, INC.3 | 11910 ANDERSON MILL ROAD AUSTIN, TX 78726 | AMERITAS | $7K | — | $7K | 5.50% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 625 KENMOOR AVE SE STE 200 GRAND RAPIDS, MI 49546 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | — | $1K | 15.01% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 15162 COLLECTIONS CENTER DR. CHICAGO, IL 60693 | EYEMED VISION CARE | $693 | — | $693 | 9.52% |
| ASSURANCE AGENCY LTD3 Filed as: ASSURANCE AGENCY | 1750 E. GOLF ROAD SCHAUMBURG, IL 60173 | EYEMED VISION CARE | $72 | — | $72 | 0.99% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 625 KENMOOR AVE SE STE 200 GRAND RAPIDS, MI 49546 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | — | $1K | 15.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 625 KENMOOR AVE SE STE 200 GRAND RAPIDS, MI 49546 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $470 | — | $470 | 10.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 625 KENMOOR AVE SE STE 200 GRAND RAPIDS, MI 49546 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $435 | — | $435 | 9.99% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| FRINGE INSURANCE BENEFITS INC EIN 74-2616364 CONTRACT ADMINISTRATOR | Plan Administrator Service code 14 | 11910 ANDERSON MILL RD AUSTIN, TX 78726 | $52K |
| HUB INTERNATIONAL MIDWEST LTD EIN 35-0672425 BROKER | Insurance brokerage commissions and fees; Insurance agents and brokers Service code 22 | 55 EAST JACKSON BLVD., FL 12 CHICAGO, IL 60604 | $14K |
| FIRST HEALTH EIN 20-1736437 CLAIM PROCESSING | Claims processing; Contract Administrator Service code 12 | 3200 HIGHLAND AVENUE DOWNERS GROVE, IL 60515 | $9K |
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 | 434 | 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) | 434 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUECROSS BLUESHIELD OF ILLINOIS | 771 | $1.3M |
| Dental(2 contracts, 2 carriers) | BLUECROSS BLUESHIELD OF ILLINOIS | 771 | $1.1M |
| Vision(2 contracts, 2 carriers) | AMERITAS | 771 | $136K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 134 | $12K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 24 | $5K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 25 | $7K |
| Other(3 contracts, 2 carriers) | NATIONWIDE | 771 | $355K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 771 | — |
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.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.