| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST | 55 W MONROE STE 500 CHICAGO, IL 60603 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $17K | $17K | 2.25% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 55 E JACKSON BLVD SUITE 1400 CHICAGO, IL 60604 | METROPOLITAN LIFE INSURANCE COMPANY | $17K | — | $17K | 2.47% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 16253 COLLECTIONS CENTER DRIVE CHICAGO, IL 60693 | METROPOLITAN LIFE INSURANCE COMPANY | — | $11K | $11K | 1.63% |
| FST ASSOCIATES INC3 Filed as: FST ASSOCIATES | 55 WEST MONROE ST STE 500 CHICAGO, IL 60603 | METROPOLITAN LIFE INSURANCE COMPANY | $6K | $2K | $8K | 1.15% |
| FST ASSOCIATES INC3 Filed as: FST ASSOCIATES, INC. | 55 W MONROE SUITE 500 CHICAGO, IL 60603 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $6K | — | $6K | 0.95% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST LTD | 55 W MONROE SUITE 500 CHICAGO, IL 60603 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $4K | — | $4K | 0.69% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 55 E JACKSON CHICAGO, IL 60604 | EYEMED VISION CARE | $22K | — | $22K | 5.18% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST | 55 WEST MONROE STE 500 CHICAGO, IL 60603 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $1K | $1K | 1.95% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST | 55 WEST MONROE STE 500 CHICAGO, IL 60603 | CIGNA LIFE INSURANCE CO. OF NEW YORK | — | $146 | $146 | 1.83% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UNITEDHEALTH CARE EIN 41-1289245 CLAIMS PROCESSOR | Other services; Claims processing Service code 12 | — | $2.7M |
| CIGNA HEALTH & LIFE INSURANCE EIN 59-1031071 FMLA PLAN ADMINISTRATOR | Non-monetary compensation; Named fiduciary; Participant communication; Float revenue; Direct payment from the plan; Contract Administrator; Other services; Claims processing Service code 12 | — | $262K |
| HUB INTERNATIONAL MIDWEST LTD EIN 35-0672425 BROKER | Other commissions Service code 55 | — | $18K |
| FST ASSOCIATES, INC. EIN 36-3832755 BROKER | Other commissions Service code 55 | — | $14K |
| CIGNA | Non-monetary compensation; Claims processing; Other services; Float revenue; Named fiduciary; Participant communication; Contract Administrator; Direct payment from the plan Service code 12 | — | $0 |
| HUB INTERNATIONAL MIDWEST LIMITED EIN 35-0672425 BROKER | Other commissions Service code 55 | 55 E JACKSON BLVD CHICAGO, IL 60604 | $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 | 6,409 | 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) | 6,409 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 2,322 | $636K |
| Vision | EYEMED VISION CARE | 9,447 | $429K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 6,409 | $682K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 5,670 | $773K |
| Other(5 contracts, 5 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 7,025 | $1.6M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 9,447 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.