| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| FOREST FINANCIAL GROUP INC3 Filed as: FOREST FINANCIAL GROUP | 580 NORTH BANK LANE LAKE FOREST, IL 60045 | CONNECTICUT GENERAL LIFE INSURANCE COMPANY | $83K | — | $83K | 11.50% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST LIMI | 580 NORTH BANK LANE LAKE FOREST, IL 60045 | GUARDIAN | $26K | $13K | $39K | 9.40% |
| FOREST FINANCIAL GROUP INC3 | 580 N BANK LN STE 101 LAKE FOREST, IL 600455303 | METROPOLITAN LIFE INSURANCE COMPANY | $22K | — | $22K | 10.15% |
| EUCLID INSURANCE SERVICES INC3 Filed as: EUCLID INSURANCE | 234 SPRING LAKE DR ITASCA, IL 601433202 | METROPOLITAN LIFE INSURANCE COMPANY | $6K | — | $6K | 2.87% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST LTD | 15162 COLLECTION CENTER DR CHICAGO, IL 606930151 | METROPOLITAN LIFE INSURANCE COMPANY | $4K | — | $4K | 1.71% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST LIMI | 580 NORTH BANK LANE LAKE FOREST, IL 60045 | GUARDIAN | $6K | $1K | $7K | 12.48% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CONNECTICUT HEALTH AND LIFE INSUR EIN 59-1031071 CUSTODIAN | Named fiduciary; Participant communication; Float revenue; Claims processing; Other services; Direct payment from the plan; Contract Administrator; Non-monetary compensation Service code 12 | — | $471K |
| FOREST FINANCIAL GROUP EIN 36-4242869 INSURANCE BROKER | Direct payment from the plan; Insurance agents and brokers Service code 22 | — | $46K |
| SWARTZ, RETSON & CO., P.C EIN 35-1509921 AUDITOR | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $10K |
| CIGNA | Direct payment from the plan; Named fiduciary; Participant communication; Other services; Non-monetary compensation; Claims processing; Float revenue; Contract Administrator Service code 12 | — | $0 |
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 | 639 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 5 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Beneficiaries receiving benefits | 0 | Spouses or dependents with eligibility independent of the participant. |
| Total participants (= "Plan participants" tile) | 644 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | GUARDIAN | 618 | $416K |
| Vision | GUARDIAN | 618 | $416K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 1,225 | $217K |
| Long-term disability | GUARDIAN | 644 | $54K |
| Stop-loss / reinsurancereinsurance | CONNECTICUT GENERAL LIFE INSURANCE COMPANY | 1,446 | $723K |
| Other(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 1,225 | $271K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,446 | — |
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.