| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 55 EAST JACKSON BLVD FL 14 CHICAGO, IL 60604 | METROPOLITAN LIFE INSURANCE COMPANY | $4K | — | $4K | 13.06% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 16253 COLLECTION CENTER DR FL 4 CHICAGO, IL 60693 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $633 | $633 | 2.22% |
| MICHAEL AHLERT3 | 4049 GRAND AVENUE WESTERN SPRINGS, IL 60558 | TRUSTMARK LIFE INSURANCE | $480 | — | $480 | 5.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 15162 COLLECTION CENTER DRIVE CHICAGO, IL 60693 | VISION SERVICE PLAN | $841 | — | $841 | 10.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| STEWART C. MILLER & CO., INC. EIN 35-1820020 NONE | Plan Administrator Service code 14 | 2111 WEST LINCOLN HIGHWAY MERRILLVILLE, IN 46140 | $37K |
| ANTHEM BLUE CROSS AND BLUE SHIELD EIN 35-0781558 NONE | Insurance services Service code 23 | P.O. BOX 951254 CLEVELAND, OH 44193 | $36K |
| HUB INTERNATIONAL EIN 35-0672425 NONE | Insurance agents and brokers; Consulting (general) Service code 16 | 55 EAST JACKSON BLVD CHICAGO, IL 60604 | $26K |
| ALLIED BENEFIT SYSTEMS, INC. EIN 36-3086057 NONE | Claims processing Service code 12 | 200 WEST ADAMS STREET STE 500 CHICAGO, IL 60606 | $23K |
| CHEIRON EIN 13-4215617 NONE | Actuarial Service code 11 | 230 WEST MONROE STREET SUITE 2150 CHICAGO, IL 60606 | $14K |
| MCM CPAS & ADVISORS LLP EIN 27-1235638 NONE | Accounting (including auditing) Service code 10 | 462 SOUTH FOURTH STREET STE 2600 LOUISVILLE, KY 40202 | $12K |
| URDA PROFESSIONAL CORPORATION EIN 35-1755675 NONE | Legal Service code 29 | 112 WEST JEFFERSON BLVD 503 SOUTH BEND, IN 46601 | $6K |
| 1ST SOURCE NONE | Other services; Claims processing; Plan Administrator Service code 12 | P.O. BOX 1602 SOUTH BEND, IN 46634 | $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 | 85 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 21 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 106 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 123 | $29K |
| Vision | VISION SERVICE PLAN | 65 | $8K |
| Life insurance | TRUSTMARK LIFE INSURANCE | 114 | $10K |
| Short-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 123 | $29K |
| Other | TRUSTMARK LIFE INSURANCE | 114 | $10K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 123 | — |
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.