| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 | 55 E JACKSON BLVD CHICAGO, IL 60604 | BLUECROSS BLUESHIELD OF ILLINOIS | $51K | — | $51K | 1.49% |
| VISTA NATIONAL INSURANCE GROUP INC3 Filed as: VISTA NATIONAL INSURANCE GROUP INC. | 1301 W 22ND STREET #600 OAK BROOK, IL 60523 | BLUECROSS BLUESHIELD OF ILLINOIS | — | $4K | $4K | 0.11% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 55 E JACKSON BLVD FL 14 CHICAGO, IL 606044466 | METROPOLITAN LIFE INSURANCE COMPANY | $10K | $21 | $10K | 5.65% |
| VISTA NATIONAL INSURANCE GROUP INC3 Filed as: VISTA NATIONAL INS GROUP INC | 1301 W 22ND ST STE 600 OAK BROOK, IL 605232010 | METROPOLITAN LIFE INSURANCE COMPANY | $714 | $2K | $3K | 1.49% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 16253 COLLECTION CENTER DR W 40 W MADISON 4TH FL BANK OF AMERICA CHICAGO, IL 606930162 | METROPOLITAN LIFE INSURANCE COMPANY | — | $3K | $3K | 1.45% |
| 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 | $14K | $2K | $16K | 15.44% |
| 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 | $9K | $1K | $10K | 20.55% |
| 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 | $7K | $921 | $8K | 17.02% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE INC | P.O. BOX 2158 RIVERSIDE, CA 92516 | HEALTHIEST YOU | $5K | — | $5K | 15.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 15162 COLLECIION CENTER DR CHICAGO, IL 606930001 | VISION SERVICE PLAN | $2K | — | $2K | 5.37% |
| VISTA NATIONAL INSURANCE GROUP INC3 | 1301 W 22ND ST SUITE 600 OAK BROOK, IL 605232010 | METROPOLITAN LIFE INSURANCE COMPANY | $1K | — | $1K | 63.16% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| EMPLOYEE BENEFITS CORPORATION EIN 39-2044064 CONTRACT ADMINISTRATOR | Claims processing; Contract Administrator Service code 12 | — | $9K |
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 | 505 | 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) | 505 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUECROSS BLUESHIELD OF ILLINOIS | 517 | $3.5M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 565 | $181K |
| Vision | VISION SERVICE PLAN | 333 | $31K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 505 | $104K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 505 | $104K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 505 | $104K |
| Other(4 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 505 | $199K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 565 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.