| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MERITAIN HEALTH3 | 509 PROGRESS DRIVE, SUITE 117 LINTHICUM, MD 21090 | HCC LIFE INSURANCE COMPANY | $7K | — | $7K | 2.50% |
| AXION RMS LTD3 | 2651 WARRENVILLE ROAD SUITE 200 DOWNERS GROVE, IL 60515 | GUARDIAN LIFE INSURANCE COMPANY | $16K | $10K | $26K | 14.50% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST LTD | 55 EAST JACKSON BLVD CHICAGO, IL 60604 | GUARDIAN LIFE INSURANCE COMPANY | $23K | — | $23K | 12.96% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 15162 COLLECTION CENTER DR CHICAGO, IL 606930001 | VISION SERVICE PLAN | $2K | — | $2K | 5.98% |
| AXION RMS LTD3 Filed as: AXION RMS, LTD | 2651 WARRENVILLE ROAD, STE 200 DOWNERS GROVE, IL 60515 | VISION SERVICE PLAN | $1K | — | $1K | 4.03% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| MERITAIN HEALTH EIN 16-1264154 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | — | $126K |
| HUB INTERNATIONAL MIDWEST LTD BROKER | Other commissions Service code 55 | 55 E JACKSON BLVD CHICAGO, IL 60604 | $11K |
| AXION RMS LTD BROKER | Other commissions Service code 55 | 2651 WARRENVILLE RD STE 200 DOWNERS GROVE, IL 605155763 | $11K |
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 | 150 | 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) | 150 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HCC LIFE INSURANCE COMPANY | 123 | $297K |
| Dental | GUARDIAN LIFE INSURANCE COMPANY | 150 | $181K |
| Vision | VISION SERVICE PLAN | 147 | $25K |
| Life insurance | GUARDIAN LIFE INSURANCE COMPANY | 150 | $181K |
| Short-term disability | GUARDIAN LIFE INSURANCE COMPANY | 150 | $181K |
| Long-term disability | GUARDIAN LIFE INSURANCE COMPANY | 150 | $181K |
| Other | GUARDIAN LIFE INSURANCE COMPANY | 150 | $181K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 150 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.