| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 | 100 SUNNYSIDE BLVD WOODBURY, NY 11797 | CONNECTICUT GENERAL LIFE INSURANCE COMPANY | $85K | — | $85K | 10.62% |
| FOREST FINANCIAL GROUP INC3 Filed as: FOREST FINANCIAL GROUP | 580 NORTH BANK LANE LAKE FOREST, IL 60045 | CONNECTICUT GENERAL LIFE INSURANCE COMPANY | $7K | — | $7K | 0.88% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST LTD | 55 EAST JACKSON BOULEVARD CHICAGO, IL 60604 | GUARDIAN | $29K | $11K | $40K | 8.82% |
| FOREST FINANCIAL GROUP INC3 | 580 N BANK LN STE 101 LAKE FOREST, IL 600455303 | METROPOLITAN LIFE INSURANCE COMPANY | $23K | — | $23K | 9.93% |
| EUCLID INSURANCE SERVICES INC3 Filed as: EUCLID INSURANCE | PO BOX 62889 VIRGINIA BEACH, VA 234662889 | METROPOLITAN LIFE INSURANCE COMPANY | $6K | — | $6K | 2.70% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST LTD | 55 EAST JACKSON BOULEVARD CHICAGO, IL 60604 | GUARDIAN | $7K | $3K | $10K | 16.03% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CONNECTICUT HEALTH AND LIFE INSUR EIN 59-1031071 CUSTODIAN | Participant communication; Contract Administrator; Claims processing; Named fiduciary; Other services; Non-monetary compensation; Direct payment from the plan; Float revenue Service code 12 | — | $433K |
| HUB INTERNATIONAL MIDWEST LIMITED INSURANCE BROKER | Insurance agents and brokers; Direct payment from the plan Service code 22 | 100 SUNNYSIDE BLVD WOODBURY, NY 11797 | $44K |
| FOREST FINANCIAL GROUP EIN 36-4242869 INSURANCE BROKER | Direct payment from the plan; Insurance agents and brokers Service code 22 | — | $4K |
| CIGNA | Claims processing; Non-monetary compensation; Direct payment from the plan; Float revenue; Contract Administrator; Participant communication; Named fiduciary; Other services 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 | 722 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | 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) | 726 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | GUARDIAN | 684 | $453K |
| Vision | GUARDIAN | 684 | $453K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 1,287 | $236K |
| Short-term disability | GUARDIAN | 737 | $62K |
| Long-term disability | GUARDIAN | 737 | $62K |
| Stop-loss / reinsurancereinsurance | CONNECTICUT GENERAL LIFE INSURANCE COMPANY | 1,582 | $805K |
| Other | METROPOLITAN LIFE INSURANCE COMPANY | 1,287 | $236K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,582 | — |
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.