| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 | 3635 RIVERSIDE PLAZA DR SUITE 300 RIVERSIDE, CA 92506 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $168K | — | $168K | 4.32% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST LTD | 15162 COLLECTIONS CENTER DRIVE CHICAGO, IL 606930001 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $78K | — | $78K | 2.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 3635 RIVERSIDE PLAZA DR RIVERSIDE, CA 92506 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $131K | — | $131K | 5.45% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 500 COUNTRY PINE LANE BATTLE CREEK, MI 490154177 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $72K | — | $72K | 3.00% |
| CARRION, LAFFITTE & CASELLAS, INC.3 Filed as: CARRION LAFFITTE & CASELLAS | 255 AVE PONCE DE LEON SAN JUAN, PR 00917 | TRIPLE S SALUD, INC. | $29K | — | $29K | 5.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CHOICE HEALTH PLAN EIN 97-0768835 CONTRACT ADMINISTRATOR | Direct payment from the plan; Claims processing Service code 12 | — | $3.5M |
| AETNA LIFE INSURANCE COMPANY EIN 06-6033492 CONTRACT ADMINISTRATOR | Direct payment from the plan; Claims processing; Contract Administrator Service code 12 | — | $2.7M |
| UNITED HEALTH CARE EIN 36-2739571 CONTRACT ADMINISTRATOR | Direct payment from the plan; Other commissions; Other services; Claims processing Service code 12 | — | $2.6M |
| ALIGHT SOLUTIONS LLC EIN 82-1061233 NONE | Consulting (general); Recordkeeping and information management (computing, tabulating, data processing, etc.); Direct payment from the plan Service code 15 | — | $1.6M |
| UNITED BEHAVIORAL HEALTH EIN 94-2649097 CONTRACT ADMINISTRATOR | Plan Administrator; Claims processing; Other services Service code 12 | — | $481K |
| EXPRESS SCRIPTS, INC. EIN 43-1420563 CONTRACT ADMINISTRATOR | Direct payment from the plan; Claims processing Service code 12 | — | $397K |
| HUB INTERNATIONAL NONE | Insurance agents and brokers; Direct payment from the plan Service code 22 | 55 E. JACKSON BOULEVARD 14TH FLOOR CHICAGO, IL 60604 | $259K |
| AON CONSULTING EIN 22-2230064 NONE | Consulting (pension); Direct payment from the plan Service code 17 | — | $106K |
| ERNST & YOUNG EIN 34-6565596 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $80K |
| NORTHERN TRUST CORPORATION EIN 36-1561860 NONE | Direct payment from the plan; Other fees; Float revenue Service code 50 | — | $8K |
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 | 16,354 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1,429 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 17,783 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | TRIPLE S SALUD, INC. | 82 | $576K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 8,306 | $3.9M |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 7,872 | $2.4M |
| Prescription drug | TRIPLE S SALUD, INC. | 82 | $576K |
| Other | TRIPLE S SALUD, INC. | 82 | $576K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 8,306 | — |
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.