| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 | 55 EAST JACKSON BLVD CHICAGO, IL 60604 | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $85K | — | $85K | 12.50% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 55 E. JACKSON BLVD, 14TH FLOOR A CHICAGO, IL 60604 | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | $39K | $7K | $46K | 12.61% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 55 E JACKSON BLVD, 14TH FLOOR A CHICAGO, IL 60604 | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | $24K | $3K | $27K | 19.98% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATINAL MIDWEST LIMITED | 55 E JACKSON BLVD, 14TH FL A CHICAGO, IL 60604 | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | — | $226 | $226 | 1.98% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UNITED HEALTHCARE SERVICES, INC. EIN 41-1289245 CLAIMS PROCESSOR | Other services; Claims processing Service code 12 | — | $772K |
| DELTA DENTAL OF WISCONSIN EIN 39-6094742 THIRD PARTY ADMINISTRATO | Insurance agents and brokers; Contract Administrator Service code 13 | — | $46K |
| RX BENEFITS EIN 63-1157085 CLAIMS PROCESSOR | Claims processing; Contract Administrator Service code 12 | — | $17K |
| LIBERTY LIFE ASSURANCE CO OF BOSTON EIN 04-6076039 CLAIMS PROCESSOR | Claims processing Service code 12 | — | $17K |
| UNITED HEALTHCARE SERICES, INC. EIN 41-1289245 CLAIMS PROCESSOR | Other services; Claims processing Service code 12 | — | $3K |
| HUB INTERNATIONAL MIDWEST LTD BROKER | Insurance agents and brokers Service code 22 | 55 E JACKSON BLVD CHICAGO, ID 60604 | $2K |
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 | 1,045 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 5 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,050 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | 992 | $367K |
| Short-term disability | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | 49 | $11K |
| Long-term disability | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | 687 | $135K |
| Stop-loss / reinsurancereinsurance | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 943 | $684K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 992 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.