| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 55 E JACKSON BLVD CHICAGO, IL 60604 | METROPOLITAN LIFE INSURANCE COMPANY | $163K | $55 | $163K | 10.11% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 16253 COLLECTIONS CENTER DRIVE 40 W MADISON 4TH FL CHICAGO, IL 60693 | METROPOLITAN LIFE INSURANCE COMPANY | — | $26K | $26K | 1.58% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 55 E JACKSON BOULEVARD 14TH FLOOR A CHICAGO, IL 60604 | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | — | $13K | $13K | 2.11% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 55 E JACKSON BLVD CHICAGO, IL 606044466 | METROPOLITAN LIFE INSURANCE COMPANY | $29K | $55 | $29K | 5.10% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 16253 COLLECTION CENTER DR 40 W MADISON 4TH FL BAN OF AMERICA CHICAGO, IL 606930162 | METROPOLITAN LIFE INSURANCE COMPANY | — | $9K | $9K | 1.57% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST LTD | 55 E JACKSON BLVD CHICAGO, IL 60604 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $7K | — | $7K | 1.69% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 55 E JACKSON BLVD. CHICAGO, IL 60604 | EYEMED VISION CARE | $14K | — | $14K | 4.30% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST LTD | 55 E JACKSON BLVD CHICAGO, IL 60604 | CIGNA DENTAL HEALTH OF KENTUCKY, INC. | $3K | — | $3K | 1.71% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 55 E JACKSON BLVD 14TH FLOOR A CHICAGO, IL 60604 | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | — | $1K | $1K | 1.23% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST LTD | 55 E JACKSON BLVD CHICAGO, IL 60604 | CIGNA DENTAL HEALTH OF FLORIDA, INC. | $985 | — | $985 | 1.71% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST LTD | 55 E JACKSON BLVD CHICAGO, IL 60604 | CIGNA DENTAL HEALTH OF CALIFORNIA, INC. | $729 | — | $729 | 1.65% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST LTD | 55 E JACKSN BLVD CHICAGO, IL 60604 | CIGNA DENTAL HEALTH PLAN OF ARIZONA, INC. | $708 | — | $708 | 1.78% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST LTD | 55 E JACKSON BLVD CHICAGO, IL 60604 | CIGNA DENTAL HEALTH OF TEXAS, INC. | $337 | — | $337 | 1.52% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST LTD | 55 E JACKSON BLVD CHICAGO, IL 60604 | CIGNA DENTAL HEALTH OF OHIO, INC. | $257 | — | $257 | 1.94% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST LTD | 55 E JACKSON BLVD CHICAGO, IL 60604 | CIGNA DENTAL HEALTH OF MISSOURI, INC. | $163 | — | $163 | 1.84% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST LTD | 55 E JACKSON BLVD CHICAGO, IL 60604 | CIGNA DENTAL HEALTH OF NORTH CAROLINA, INC. | $112 | — | $112 | 1.27% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST LTD | 55 E JACKSON BLVD CHICAGO, IL 60604 | CIGNA DENTAL HEALTH OF COLORADO, INC | $52 | — | $52 | 1.18% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNTIONAL MIDWEST LTD | 55 E JACKSON BLVD CHICAGO, IL 60604 | CIGNA DENTAL HEALTH OF PENNSYLVANIA, INC. | $62 | — | $62 | 1.40% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST LTD | 55 E JACKSON BLVD CHICAGO, IL 60604 | CIGNA DENTAL HEALTH OF MARYLAND, INC. | $60 | — | $60 | 1.36% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST LTD | 55 E JACKSON BLVD CHICAGO, IL 60604 | CIGNA DENTAL HEALTH OF VIRGINIA, INC. | $66 | — | $66 | 1.49% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UNITEDHEALTH CARE SERVICES, INC EIN 41-1289245 CLAIMS PROCESSOR | Claims processing; Other services Service code 12 | — | $2.0M |
| CIGNA HEALTH & LIFE INSURANCE EIN 59-1031071 PLAN ADMINISTRATOR | Claims processing; Float revenue; Other services; Participant communication; Direct payment from the plan; Non-monetary compensation; Contract Administrator; Named fiduciary Service code 12 | — | $193K |
| LIBERTY LIFE ASSURANCE CO OF BOSTON EIN 04-6076039 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | — | $139K |
| HUB INTERNATIONAL MIDWEST LTD EIN 35-0672425 BROKER | Other commissions Service code 55 | 55 E JACKSON BLVD CHICAGO, IL 60604 | $23K |
| CIGNA | Claims processing; Direct payment from the plan; Contract Administrator; Float revenue; Other services; Named fiduciary; Participant communication; Non-monetary compensation Service code 12 | — | $0 |
| HUB INTERNATIONAL MIDWEST LIMITED EIN 35-0672425 BROKER | Other commissions Service code 55 | 55 E JACKSON BOULEVARD, 14 FLOOR A 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 | 5,548 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 54 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 5,602 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental(13 contracts, 13 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 1,286 | $818K |
| Vision | EYEMED VISION CARE | 5,559 | $331K |
| Life insurance(2 contracts) | METROPOLITAN LIFE INSURANCE COMPANY | 5,548 | $2.2M |
| Long-term disability | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | 3,355 | $635K |
| Stop-loss / reinsurancereinsurance | UNITED HEALTHCARE INSURANCE COMPANY | 5,597 | $936K |
| Other(7 contracts, 5 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 5,597 | $3.9M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 5,597 | — |
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.
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.