| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| VISTA NATIONAL INSURANCE GROUP INC3 | 1301 W 22ND ST, SUITE 600 OAK BROOK, IL 60523 | BLUECROSS BLUESHIELD OF ILLINOIS | $64K | $1 | $64K | 1.99% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 55 E JACKSON BLVD, 12TH FL CHICAGO, IL 60604 | BLUECROSS BLUESHIELD OF ILLINOIS | — | $3K | $3K | 0.10% |
| REPUBLIC BANCORP3 | 2221 CAMDEN COURT OAK BROOK, IL 60523 | BLUECROSS BLUESHIELD OF ILLINOIS | — | $5 | $5 | 0.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 55 E JACKSON BLVD #14B CHICAGO, IL 60604 | BLUECROSS BLUESHIELD OF ILLINOIS | — | $1 | $1 | 0.00% |
| VISTA NATIONAL INSURANCE GROUP INC3 Filed as: VISTA NATIONAL INS GRP INC | 1301 W 22ND STREET SUITE 600 OAK BROOK, IL 60523 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $5K | $5K | 6.91% |
| VISTA NATIONAL INSURANCE GROUP INC3 Filed as: VISTA NATIONAL INS GRP INC | 1301 W 22ND ST SUITE 600 OAK BROOK, IL 60523 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $4K | $4K | 6.90% |
| VISTA NATIONAL INSURANCE GROUP INC3 Filed as: VISTA NATIONAL INS GRP INC | 1301 W 22ND ST SUITE 600 OAK BROOK, IL 60523 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $3K | $3K | 6.93% |
| VISTA NATIONAL INSURANCE GROUP INC3 Filed as: VISTA NATIONAL INS GRP INC | 1301 W 22ND STREET SUITE 600 OAK BROOK, IL 60523 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $2K | $2K | 7.19% |
| VISTA NATIONAL INSURANCE GROUP INC3 Filed as: VISTA NATIONAL INSURANCE GROUP | 1301 W 22ND ST, SUITE 600 OAK BROOK, IL 60523 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $5K | — | $5K | 20.22% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST LTD | EMPLOYEE BENEFITS DEPT 55 E JACKSON BLVD, #14A CHICAGO, IL 60604 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $476 | — | $476 | 1.83% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 55 E JACKSON BLVD CHICAGO, IL 60604 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $247 | — | $247 | 0.95% |
| RUMMEL, SERAPHIM, MICHAEL3 | 180 N LASALLE SUITE 3100 CHICAGO, IL 60601 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $125 | — | $125 | 0.48% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 55 E. JACKSON BLVD CHICAGO, IL 60604 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $1K | — | $1K | 4.48% |
| VISTA NATIONAL INSURANCE GROUP INC3 Filed as: VISTA NATIONAL INSURANCE GROUP, INC | 1301 WEST 22ND STREET OAK BROOK, IL 60523 | FIDELITY SECURITY LIFE INSURANCE COMPANY | -$226 | — | -$226 | -0.90% |
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 | 314 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 6 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 320 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUESHIELD OF ILLINOIS | 617 | $3.2M |
| Dental | BLUECROSS BLUESHIELD OF ILLINOIS | 617 | $3.2M |
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY | 485 | $25K |
| Life insurance(2 contracts) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 311 | $78K |
| Short-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 311 | $66K |
| Long-term disability(2 contracts, 2 carriers) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 311 | $77K |
| Prescription drug | BLUECROSS BLUESHIELD OF ILLINOIS | 617 | $3.2M |
| Other(3 contracts, 2 carriers) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 311 | $112K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 617 | — |
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.