| 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 | $183K | — | $183K | 5.05% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST LTD | 15162 COLLECTIONS CENTER DRIVE CHICAGO, IL 606930001 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $72K | — | $72K | 2.00% |
| SEDGWICK CLAIMS MANAGEMENT SERVICES5 Filed as: SEDGWICK CLAIMS MGMT SERVICES INC. | 2620 THOUSAND OAKS BLVD. MEMPHIS, TN 38118 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $1.1M | $1.1M | 50.76% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | SUITE 300 3635 RIVERSIDE PLAZA DR RIVERSIDE, CA 92506 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $113K | — | $113K | 5.20% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | PO BOX 2167 GRAND RAPIDS, MI 49501 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $66K | — | $66K | 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. | $28K | — | $28K | 5.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CHOICE HEALTH PLAN EIN 97-0768835 CONTRACT ADMINISTRATOR | Claims processing; Direct payment from the plan Service code 12 | — | $3.7M |
| AETNA LIFE INSURANCE COMPANY EIN 06-6033492 CONTRACT ADMINISTRATOR | Contract Administrator; Direct payment from the plan; Claims processing Service code 12 | — | $3.2M |
| UNITED HEALTH CARE EIN 36-2739571 CONTRACT ADMINISTRATOR | Direct payment from the plan; Claims processing Service code 12 | — | $2.7M |
| EXPRESS SCRIPTS, INC. EIN 43-1420563 CONTRACT ADMINISTRATOR | Claims processing; Direct payment from the plan Service code 12 | — | $1.0M |
| 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 | — | $740K |
| UNITED BEHAVIORAL HEALTH EIN 94-2649097 CONTRACT ADMINISTRATOR | Claims processing; Plan Administrator; Other services Service code 12 | — | $445K |
| KAISER PERMANENTE EIN 94-1340523 CONTRACT ADMINISTRATOR | Claims processing; Direct payment from the plan Service code 12 | — | $406K |
| HUB INTERNATIONAL NONE | Insurance agents and brokers; Direct payment from the plan Service code 22 | 55 E. JACKSON BOULEVARD 14TH FLOOR CHICAGO, IL 60604 | $220K |
| AON CONSULTING EIN 22-2230064 NONE | Consulting (pension); Direct payment from the plan Service code 17 | — | $210K |
| ROC NONE | Claims processing; Direct payment from the plan Service code 12 | 300 E. RANDOLPH ST SUITE 3400 CHICAGO, IL 60601 | $122K |
| MAXIM HEALTHCARE SERVICES EIN 52-1590951 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $92K |
| ERNST & YOUNG EIN 34-6565596 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $68K |
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 | 16,182 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1,253 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 17,435 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | TRIPLE S SALUD, INC. | 85 | $562K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 8,023 | $3.6M |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 7,906 | $2.2M |
| Prescription drug | TRIPLE S SALUD, INC. | 85 | $562K |
| Other | TRIPLE S SALUD, INC. | 85 | $562K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 8,023 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.