| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 | 55 E. JACKSON BLVD, 14TH FLOOR A CHICAGO, IL 60604 | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | $32K | $7K | $39K | 11.23% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 55 E JACKSON BLVD, 14TH FLOOR A CHICAGO, IL 60604 | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | $22K | $3K | $25K | 17.06% |
| 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 | — | $231 | $231 | 1.99% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ANTHEM INSURANCE COMPANIES, INC EIN 35-0781558 CLAIMS PROCESSOR | Claims processing; Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.); Float revenue; Other services Service code 12 | — | $704K |
| LIBERTY LIFE ASSURANCE CO OF BOSTON EIN 04-6076039 CLAIMS PROCESSOR | Claims processing Service code 12 | — | $26K |
| RXBENEFITS, INC EIN 63-1157085 CLAIMS PROCESSOR | Contract Administrator; Claims processing Service code 12 | — | $17K |
| LIBERTY LIFE ASSU CO OF BOSTON EIN 04-6076039 CLAIM PROCESSOR | Claims processing Service code 12 | — | $16K |
| DELTA DENTAL OF WISCONSIN EIN 39-6094742 THIRD PARTY ADMINISTRATO | Contract Administrator Service code 13 | — | $2K |
| HUB INTERNATIONAL MIDWEST LIMITED BROKER | Other commissions Service code 55 | 55 E JACKSON BLVD 14TH FLOOR A CHICAGO, IL 60604 | $779 |
| HUB INTERNATIONAL MIDWEST LTD EIN 35-0781558 BROKER | Other commissions; Insurance brokerage commissions and fees; Insurance agents and brokers Service code 22 | 55 E JACKSON BLVD CHICAGO, IL 60604 | $0 |
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 | 1,060 | 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) | 1,060 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision(2 contracts) | EYEMED VISION CARE | 2,247 | $63K |
| Life insurance | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | 1,018 | $350K |
| Short-term disability | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | 50 | $12K |
| Long-term disability | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | 685 | $148K |
| Stop-loss / reinsurancereinsurance | ANTHEM INSURANCE COMPANIES, INC. | 2,302 | $548K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,302 | — |
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.