| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED0 | 55 E JACKSON BLVD CHICAGO, IL 60604 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $2K | — | $2K | 1.41% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 55 E JACKSON BLVD CHICAGO, IL 60604 | EYEMED VISION CARE | $4K | — | $4K | 3.70% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 16253 COLLECTION CENTER DR CHICAGO, IL 60693 | METROPOLITAN LIFE INSURANCE COMPANY | $370 | $54 | $424 | 26.73% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UNITED HEATHCARE SERVICES, INC EIN 41-1289245 CLAIMS PROCESSOR | Other services; Claims processing Service code 12 | — | $504K |
| LIBERTY LIFE ASSUR CO OF BOSTON EIN 04-6076039 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | — | $49K |
| LINCOLN LIFE ASSUR CO OF BOSTON EIN 04-6076039 CONTRACT ADMINISTRATION | Contract Administrator Service code 13 | — | $27K |
| HUB INTERNATIONAL MIDWEST LIMITED EIN 35-0672425 BROKER | Other commissions Service code 55 | 1411 OPUS PL STE 450 DOWNERS GROVE, IL 605151423 | $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 | 1,315 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,315 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 564 | $165K |
| Vision | EYEMED VISION CARE | 2,182 | $105K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 1,669 | $39K |
| Long-term disability | LINCOLN LIFE ASSURANCE COMPANY OF BOSTON | 1,494 | $203K |
| Stop-loss / reinsurancereinsurance | UNITEDHEALTHCARE INSURANCE COMPANY | 2,194 | $1.2M |
| Other(5 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 1,669 | $212K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,194 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.
Broker comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.