| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 55 EAST JACKSON BOULEVARD CHICAGO, IL 60604 | THE HARTFORD | $16K | — | $16K | 2.31% |
| THE FEDELI GROUP3 | 5005 ROCKSIDE ROAD 5TH FLOOR INDEPENDENCE, OH 44131 | THE HARTFORD | $4K | — | $4K | 0.54% |
| MARSH & MCLENNAN AGENCY LLC3 | 2300 RENANAISSANCE BLVD KING OF PRUSSIA, PA 19406 | THE HARTFORD | — | $2K | $2K | 0.25% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 55 EAST JACKSON BOULEVARD CHICAGO, IL 60604 | UNITED HEALTHCARE | $9K | — | $9K | 10.84% |
| THE FEDELI GROUP3 | 5005 ROCKSIDE ROAD 5TH FLOOR INDEPENDENCE, OH 44131 | UNITED HEALTHCARE | $1K | — | $1K | 1.59% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| AETNA LIFE INSURANCE COMPANY EIN 06-6033492 VENDOR | Contract Administrator Service code 13 | 151 FARMINGTON AVENUE HARTFORD, CT 06156 | $886K |
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 | 2,173 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 2,173 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | AETNA LIFE INSURANCE COMPANY | 2,173 | $64.9M |
| Vision | UNITED HEALTHCARE | 1,254 | $83K |
| Life insurance | THE HARTFORD | 1,438 | $684K |
| Short-term disability | THE HARTFORD | 1,438 | $684K |
| Long-term disability | THE HARTFORD | 1,438 | $684K |
| Other | THE HARTFORD | 1,438 | $684K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,173 | — |
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 comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
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.