| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 | 55 E JACKSON BLVD CHICAGO, IL 60604 | SUN LIFE ASSURANCE COMPANY OF CANADA | $12K | — | $12K | 15.25% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONL MIDWEST LTD | 55 E JACKSON BLVD #14A CHICAGO, IL 60604 | EYEMED VISION CARE | $5K | — | $5K | 9.80% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUECROSS BLUESHIELD OF IL EIN 36-1236610 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | — | $268K |
| UNION SECURITY INSURANCE COMPANY EIN 81-0170040 CLAIMS PROCESSING | Other fees; Claims processing Service code 12 | — | $28K |
| HUB INTERNATIONAL MIDWEST LTD BROKER | Insurance agents and brokers; Other commissions Service code 22 | 55 E JACKSON BLVD FL 12 CHICAGO, IL 60604 | $19K |
| CAREBRIDGE CORPORATION EIN 23-2614764 CONTRACT ADMINISTRATORS | Contract Administrator Service code 13 | — | $4K |
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 | 651 | 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) | 651 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | EYEMED VISION CARE | 848 | $50K |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 776 | $238K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 776 | $238K |
| Other(2 contracts) | SUN LIFE ASSURANCE COMPANY OF CANADA | 776 | $316K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 848 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.