| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 55 EAST JACKSON BOULEVARD SUITE 14A CHICAGO, IL 60604 | BLUE CROSS BLUE SHIELD OF ILLINOIS | $48K | $3K | $51K | 4.06% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 55 EAST JACKSON BOULEVARD SUITE 14A CHICAGO, IL 60604 | DELTA DENTAL OF ILLINOIS | $9K | $0 | $9K | 7.50% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHEAST | 100 SUNNYSIDE BLVD SUITE 400 WOODBURY, NJ 11797 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $6K | $1K | $8K | 11.98% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHEAST | 100 SUNNYSIDE BLVD SUITE 400 WOODBURY, NJ 11797 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | $311 | $1K | 10.59% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST | 55 E JACKSON BLVD STE 14A CHICAGO, IL 60604 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $228 | $0 | $228 | 1.62% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHEAST | 100 SUNNYSIDE BLVD SUITE 400 WOODBURY, NJ 11797 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $428 | $105 | $533 | 10.38% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST | 55 E JACKSON BLVD STE 14A CHICAGO, IL 60604 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $86 | $0 | $86 | 1.67% |
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 | 157 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 158 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF ILLINOIS | 236 | $1.2M |
| Dental | DELTA DENTAL OF ILLINOIS | 119 | $125K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 112 | $14K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 28 | $5K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 149 | $65K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF ILLINOIS | 236 | $1.2M |
| Other | LIFE INSURANCE COMPANY OF NORTH AMERICA | 112 | $14K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 236 | — |
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.