| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST LTD | 55 EAST JACKSON BLVD, 14TH FLOOR CHICAGO, IL 60604 | BLUECROSS BLUESHIELD OF ILLINOIS | $94K | $4K | $98K | 4.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 55 EAST JACKSON BOULEVARD CHICAGO, IL 60604 | PRINCIPAL LIFE INSURANCE COMPANY | $11K | $1K | $12K | 7.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL LIMITED | 300 N LASALLE ST 17TH FLOOR CHICAGO, IL 60604 | PRINCIPAL LIFE INSURANCE COMPANY | — | $4K | $4K | 2.38% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 55 E JACKSON BLVD CHICAGO, IL 60693 | METROPOLITAN LIFE INSURANCE COMPANY | $4K | — | $4K | 2.84% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST LTD | 16253 COLLECTION CENTER DR 40 W MADISON 4TH FLOOR CHICAGO, IL 60693 | METROPOLITAN LIFE INSURANCE COMPANY | — | $3K | $3K | 2.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 15162 COLLECTION CENTER DR CHICAGO, IL 606930001 | VISION SERVICE PLAN | $997 | — | $997 | 5.87% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| EMPLOYEE BENEFITS CORPORATION EIN 39-2044064 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | — | $13K |
| HUB INTERNATIONAL MIDWEST LTD BROKER | Other commissions Service code 55 | 55 E JACKSON BLVD CHICAGO, IL 60604 | $587 |
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 | 143 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 7 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 150 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUESHIELD OF ILLINOIS | 320 | $2.4M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 471 | $154K |
| Vision | VISION SERVICE PLAN | 130 | $17K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 143 | $166K |
| Short-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 143 | $166K |
| Long-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 143 | $166K |
| Other | HARTFORD LIFE AND ACCIDENT | 143 | $0 |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 471 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.