| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST | 55 E. JACKSON BLVD., 14TH FLOOR CHICAGO, IL 60604 | BLUECROSS BLUESHIELD OF ILLINOIS | $22K | $2K | $24K | 4.07% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST | 55 E. JACKSON BLVD., 14TH FLOOR CHICAGO, IL 60604 | DELTA DENTAL OF ILLINOIS | $1K | — | $1K | 4.61% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHEAST | 100 SUNNYSIDE BLVD., SUITE 400 WOODBURY, NY 11797 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | $431 | $2K | 11.32% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST | 55 E. JACKSON BLVD., 14TH FLOOR CHICAGO, IL 60604 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $166 | — | $166 | 0.83% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHEAST | 100 SUNNYSIDE BLVD., SUITE 400 WOODBURY, NY 11797 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | $389 | $2K | 11.33% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST | 55 E. JACKSON BLVD., 14TH FLOOR CHICAGO, IL 60604 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $149 | — | $149 | 0.82% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHEAST | 100 SUNNYSIDE BLVD., SUITE 400 WOODBURY, NY 11797 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $896 | $213 | $1K | 11.35% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST | 55 E. JACSKON BLVD., 14TH FLOOR CHICAGO, IL 60604 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $81 | — | $81 | 0.83% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST | 55 E. JACKSON BLVD., 14TH FLOOR CHICAGO, IL 60604 | PROTEC INSURANCE COMPANY | $696 | — | $696 | 9.27% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHEAST | 100 SUNNYSIDE BLVD., SUITE 400 WOODBURY, NY 11797 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $663 | — | $663 | 10.00% |
| SCHWARTZ BENEFIT SERVICES INC3 Filed as: SCHWARTZ BENEFIT SERVICES INC. | 500 W. MADISON STREET, SUITE 2700 CHICAGO, IL 60661 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $338 | — | $338 | 11.54% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST | 55 E. JACKSON BLVD., 14TH FLOOR CHICAGO, IL 60604 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $94 | $6 | $100 | 3.41% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHEAST | 100 SUNNYSIDE BLVD., SUITE 400 WOODBURY, NY 11797 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $89 | $21 | $110 | 11.34% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 55 E. JACKSON BLVD., 14TH FLOOR CHICAGO, IL 60604 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $8 | — | $8 | 0.82% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHEAST | 100 SUNNYSIDE BLVD., SUITE 400 WOODBURY, NY 11797 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $54 | — | $54 | 10.02% |
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 | 89 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 15 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 104 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUESHIELD OF ILLINOIS | 84 | $578K |
| Dental | DELTA DENTAL OF ILLINOIS | 64 | $27K |
| Vision | PROTEC INSURANCE COMPANY | 51 | $8K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 100 | $10K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 85 | $18K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 85 | $20K |
| Other(3 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 25 | $10K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 100 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.