| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 | 55 EAST JACKSON BOULEVARD SUITE 14A CHICAGO, IL 60604 | BLUECROSS BLUESHIELD OF ILLINOIS | $106K | $10K | $116K | 4.06% |
| ANSAY & ASSOCIATES LLC3 | 2901 W BELTWAY HWY STE 202 MADISON, WI 53713 | BLUECROSS BLUESHIELD OF ILLINOIS | $9K | — | $9K | 0.33% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST LTD IL | EMPLOYEE BENEFITS DEPT 55 EAST JACKSON BOULEVARD #14A CHICAGO, IL 60604 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $8K | $3K | $10K | 18.49% |
| JAMES R NELLIGAN & ASSOCIATES LLC3 Filed as: JAMES R NELLIGAN & ASSOCIATES | 1933 STATE ROUTE 35 STE 368 WALL, NJ 07719 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | — | $3K | 4.62% |
| ANSAY & ASSOCIATES LLC3 Filed as: ANSAY & ASSOCIATES | 2901 W BELTWAY HWY STE 202 MADISON, WI 53713 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $627 | $31 | $658 | 1.19% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | PO BOX 2158 RIVERSIDE, CA 92516 | VISION SERVICE PLAN | $960 | — | $960 | 4.55% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 1411 OPUS PL STE 450 DOWNERS GROVE, IL 606151423 | VISION SERVICE PLAN | $386 | — | $386 | 1.83% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST LTD | EMPLOYEE BENEFITS DEPT 55 E JACKSON BLVD #14A CHICAGO, IL 60604 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | $339 | $1K | 18.51% |
| JAMES R NELLIGAN & ASSOCIATES LLC3 Filed as: JAMES R NELLIGAN & ASSOCIATES | 1933 STATE ROUTE 35 STE 368 WALL, NJ 077193502 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $339 | — | $339 | 4.63% |
| ANSAY & ASSOCIATES LLC3 Filed as: ANSAY & ASSOCIATES | 2901 W BELTWAY HWY STE 202 MADISON, WI 53713 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $82 | $4 | $86 | 1.17% |
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 | 297 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 8 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 305 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUESHIELD OF ILLINOIS | 409 | $2.8M |
| Dental | BLUECROSS BLUESHIELD OF ILLINOIS | 409 | $2.8M |
| Vision | VISION SERVICE PLAN | 190 | $21K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 297 | $7K |
| Prescription drug | BLUECROSS BLUESHIELD OF ILLINOIS | 409 | $2.8M |
| Other(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 297 | $63K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 409 | — |
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.