| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 | 55 E JACKSON BLVD CHICAGO, IL 60604 | BLUECROSS AND BLUESHIELD OF ILLINOIS | $95K | $14K | $109K | 0.56% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST LTD | EMPLOYEE BENEFITS DEPT 55 E JACKSON BLVD #14A CHICAGO, IL 60604 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $47K | $57K | $104K | 3.66% |
| LOCKTON COMPANIES, LLC3 | C/O BANK OF AMERICA 15939 COLLECTIONS CENTER DRIVE CHICAGO, IL 60693 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $38K | $7K | $45K | 10.60% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST LTD | EMPLOYEES BENEFIT DEPT 55 E JACKSON BLVD #14A CHICAGO, IL 60604 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $14K | $8K | $22K | 5.25% |
| KME INSURANCE BROKERAGE, INC.3 | 300 SOUTH WACKER DR STE 2000 A CHICAGO, IL 60606 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $7K | $4K | $11K | 2.69% |
| AON CONSULTING INC3 Filed as: AON CONSULTING | 29840 NETWORK PLACE CHICAGO, IL 60673 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $603 | — | $603 | 0.14% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS | ADMINISTRATION, LLC-ATL 4565 PAYSPHERE CIR CHICAGO, IL 60674 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $413 | — | $413 | 0.10% |
| LOCKTON COMPANIES, LLC3 | HOME OFFICE ATTN TELLYE HEDRICK KANSAS CITY, MO 641121906 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | — | $62 | $62 | 0.01% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | EMPLOYEE BENEFITS DEPT 55 E JACKSON BVLD #14A CHICAGO, IL 60604 | UNUM INSURANCE COMPANY | $21K | $3K | $25K | 17.45% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST LTD | EMPLOYEE BENEFITS DEPT 55 E JACKSON BLVD 314A CHICAGO, IL 60604 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $9K | $8K | $17K | 18.65% |
| LOCKTON COMPANIES, LLC3 | C/O BANK OF AMERICA 15939 COLLECTIONS CENTER DR CHICAGO, IL 60693 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $7K | $1K | $8K | 8.78% |
| KME INSURANCE BROKERAGE, INC.3 | 300 SOUTH WAKER DR STE 2000 A CHICAGO, IL 60606 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $5K | $3K | $8K | 8.54% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES, LLC-HOME OFFICE | 444 W 47TH ST., STE 900 KANSAS CITY, MO 64112 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | — | $69 | $69 | 0.07% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON CO., LLC DALLAS SERIES | DEPT 3042 PO BOX 123042 DALLAS, TX 75312 | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY | $8K | $2K | $10K | 11.14% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST LTD | EMPLOYEE BENEFITS DEPT 55 E JACKSON BLVD #14A CHICAGO, IL 60604 | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY | $3K | $4K | $7K | 7.92% |
| KME INSURANCE BROKERAGE, INC.3 | 300 SOUTH WACKER DR STE 2000 A CHICAGO, IL 60606 | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY | $2K | $1K | $3K | 3.08% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST LTD | EMPLOYEE BENEFITS DEPT 55 E JACKSON BLVD #14A CHICAGO, IL 60604 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $13K | — | $13K | 15.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST LTD | EMPLOYEE BENEFITS DEPT 55 E JACKSON BLVD #14A CHICAGO, IL 60604 | FIRST UNUM LIFE INSURANCE COMPANY | — | $3K | $3K | 2.91% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST LTD | EMPLOYEE BENEFITS DEPT 55 E JACKSON BLVD #14A CHICAGO, IL 60604 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $6K | $493 | $6K | 13.67% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON CO., LLC-CHICAGO SERIES | C/O BANK OF AMERICA 15939 COLLECTIONS CENTER DR CHICAGO, IL 60693 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $64 | $2K | 3.50% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST LTD | EMPLOYEE BENEFITS DEPT 55 E JACKSON BLVD #14A CHICAGO, IL 60604 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $3K | $6K | 12.52% |
| LOCKTON COMPANIES, LLC3 | C/O BANK OF AMERICA 15939 COLLECTIONS CENTER DR CHICAGO, IL 60693 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $5K | $630 | $5K | 11.71% |
| KME INSURANCE BROKERAGE, INC.3 | 300 SOUTH WACKER DR STE 2000 A CHICAGO, IL 60606 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $1K | $3K | 5.57% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 55 E JACKSON BLVD CHICAGO, IL 60604 | KAISER FOUNDATION HEALTH PLAN OF HAWAII | $2K | — | $2K | 3.82% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 55 E JACKSON BLVD CHICAGO, IL 60604 | HAWAII DENTAL SERVICE | $778 | — | $778 | 2.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 55 E JACKSON BLVD CHICAGO, IL 60604 | FEDERAL INSURANCE COMPANY | $5K | $816 | $6K | 17.25% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST LTD | EMPLOYEE BENEFITS DEPT 55 E JACKSON BLVD #14A CHICAGO, IL 60604 | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY | $2K | $2K | $4K | 18.83% |
| KME INSURANCE BROKERAGE, INC.3 | 300 SOUTH WACKER DR STE 2000 A CHICAGO, IL 60606 | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY | $916 | $1K | $2K | 8.45% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES, LLC- | DALLAS SERIES DEPT 3042 PO BOX 123042 DALLAS, TX 75312 | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY | $2K | $295 | $2K | 8.14% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | EMPLOYEES BENEFIT DEPT 55 E JACKSON BLVD #14A CHICAGO, IL 60604 | UNUM LIFE INSURANCE COMPANY | $3K | $440 | $3K | 22.71% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST LTD | EMPLOYEE BENEFITS DEPT 55 E JACKSON BLVD #14A CHICAGO, IL 60604 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $2K | $4K | 30.59% |
| KME INSURANCE BROKERAGE, INC.3 | 300 SOUTH WACKER DR STE 2000 A CHICAGO, IL 60606 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $718 | $1K | $2K | 13.56% |
| LOCKTON COMPANIES, LLC3 | C/O BANK OF AMERICA 15939 COLLECTIONS CENTER DR CHICAGO, IL 60693 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $538 | $67 | $605 | 4.77% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST LTD | EMPLOYEE BENEFITS DEPT 55 E JACKSON BLVD #14A CHICAGO, IL 60604 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $334 | $489 | $823 | 10.80% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST LTD | EMPLOYEES BENEFIT DEPT 55 E JACKSON BLVD #14A CHICAGO, IL 60604 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $334 | $489 | $823 | 10.80% |
| LOCKTON COMPANIES, LLC3 | CHICAGO SERIES C/O BANK OF AMERICA 15939 COLLECTIONS CENTER DR CHICAGO, IL 60693 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $506 | $138 | $644 | 8.45% |
| KME INSURANCE BROKERAGE, INC.3 | 125 S WACKER DR STE 300 CHICAGO, IL 60606 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $171 | $44 | $215 | 2.82% |
| KME INSURANCE BROKERAGE, INC.3 | 125 S WACKER DR STE 300 CHICAGO, IL 60606 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $171 | $44 | $215 | 2.82% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | EMPLOYEE BENEFITS DEPT 55 E JACKSON BLVD #14A CHICAGO, IL 60604 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $193 | $193 | 4.03% |
| AON CONSULTING INC3 | 29840 NETWORK PLACE CHICAGO, IL 60673 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $146 | — | $146 | 10.42% |
| STEVEN PERSKY & ASSOCIATES LTD3 | 6 W HUBBARD STREET STE 200 CHICAGO, IL 60654 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $11 | — | $11 | 0.79% |
No Schedule C service providers reported on this filing.
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 | 1,170 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 48 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,218 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | BLUECROSS AND BLUESHIELD OF ILLINOIS | 2,321 | $20.2M |
| Dental(3 contracts, 3 carriers) | BLUECROSS AND BLUESHIELD OF ILLINOIS | 2,321 | $19.6M |
| Vision(3 contracts, 3 carriers) | HAWAII MEDICAL SERVICE ASSOCIATION | 1,022 | $731K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,519 | $2.8M |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 28 | $5K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,519 | $2.8M |
| Prescription drug | BLUECROSS AND BLUESHIELD OF ILLINOIS | 2,321 | $19.6M |
| Other(15 contracts, 7 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,684 | $3.9M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,321 | — |
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.