| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 | 55 E JACKSON BLVD CHICAGO, IL 60604 | DEARBORN LIFE INSURANCE COMPANY | $164K | — | $164K | 6.02% |
| JAMES R NELLIGAN & ASSOCIATES LLC3 | 1933 STATE ROUTE 35, STE 368 WALL TOWNSHIP, NJ 07719 | DEARBORN LIFE INSURANCE COMPANY | — | $68K | $68K | 2.50% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 55 E JACKSON BLVD FLOOR 14B CHICAGO, IL 60604 | CONTINENTAL AMERICAN INSURANCE COMPANY | $46K | — | $46K | 6.89% |
| ANGELA SCHIEK3 | 953 WILLOW LANE DUNDEE, IL 60118 | CONTINENTAL AMERICAN INSURANCE COMPANY | $7K | — | $7K | 1.09% |
| ZUREK & ASSOCIATES LLC3 | 210 DES PLAINES AVE UNIT D FOREST PARK, IL 60130 | CONTINENTAL AMERICAN INSURANCE COMPANY | $6K | — | $6K | 0.85% |
| VICKI L CIGER3 | 4020 OAK TREE LANE PLAINFIELD, IL 60586 | CONTINENTAL AMERICAN INSURANCE COMPANY | $3K | — | $3K | 0.52% |
| WESTERMAYER AND ASSOCIATES LLC3 | 14901 QUORUM RD ADDISON, TX 75254 | CONTINENTAL AMERICAN INSURANCE COMPANY | $3K | — | $3K | 0.41% |
| OVERBECK INSURANCE SERVICES3 | 1033 SOUTH BLVD OAK PARK, IL 60302 | CONTINENTAL AMERICAN INSURANCE COMPANY | $2K | — | $2K | 0.34% |
| TIFFANY ANNE KING3 Filed as: TIFFANY A KING | 1010 LAKE ST SUITE 430 OAK PARK, IL 60301 | CONTINENTAL AMERICAN INSURANCE COMPANY | $2K | — | $2K | 0.27% |
| BRIAN WHITE3 Filed as: BRIAN HANLEY | 506 CANTERBURY DRIVE LAGRANGE, GA 30241 | CONTINENTAL AMERICAN INSURANCE COMPANY | $865 | — | $865 | 0.13% |
| MARTHA A DUBOIS3 | 8431 S 84TH AVENUE HICKORY HILLS, IL 60457 | CONTINENTAL AMERICAN INSURANCE COMPANY | $643 | — | $643 | 0.10% |
| SEENA JOHN3 | 15419 W 127TH ST LEMONT, IL 60439 | CONTINENTAL AMERICAN INSURANCE COMPANY | $643 | — | $643 | 0.10% |
| MICHELLE WELTY3 | 1616 MARLBORO LN CREST HILL, IL 60403 | CONTINENTAL AMERICAN INSURANCE COMPANY | $643 | — | $643 | 0.10% |
| CHRISTOPHER A SKEETERS3 | 14 PARTRIDGE ROAD SPRINGFIELD, IL 62711 | CONTINENTAL AMERICAN INSURANCE COMPANY | $643 | — | $643 | 0.10% |
| ERIC MCCLELLAND3 Filed as: ERIC M MCCLELLAND | 6231 N 96TH STREET FOWLER, IL 62338 | CONTINENTAL AMERICAN INSURANCE COMPANY | $643 | — | $643 | 0.10% |
| MARIA J NOVOA3 | 26 COUR D'ALENE PALOS HILLS, IL 60465 | CONTINENTAL AMERICAN INSURANCE COMPANY | $643 | — | $643 | 0.10% |
| RUSSELL NOWAK3 | 8009 VALLEY DRIVE PALOS HILLS, IL 60465 | CONTINENTAL AMERICAN INSURANCE COMPANY | $643 | — | $643 | 0.10% |
| VICKI S LYNN3 | PO BOX 164 408 W MAIN ARENZVILLE, IL 62611 | CONTINENTAL AMERICAN INSURANCE COMPANY | $559 | — | $559 | 0.08% |
| NORMA HUERTA3 | 14420 S ALBANY AVE POSEN, IL 60469 | CONTINENTAL AMERICAN INSURANCE COMPANY | $334 | — | $334 | 0.05% |
| RONALD E JAGODZINSKI3 | 6 CARL ST RIVERTON, IL 62561 | CONTINENTAL AMERICAN INSURANCE COMPANY | $334 | — | $334 | 0.05% |
| EL TORRO INC3 | 14031 JOHN HUMPHREY DR ORLAND PARK, IL 60462 | CONTINENTAL AMERICAN INSURANCE COMPANY | $334 | — | $334 | 0.05% |
| COLIN M JONES3 | 1125 HAMPSHIRE SUITE 201 QUINCY, IL 62301 | CONTINENTAL AMERICAN INSURANCE COMPANY | $334 | — | $334 | 0.05% |
| THE PROFECTUS GROUP LLC3 | 30 W RUSSELL RD COLUMBUS, OH 43215 | CONTINENTAL AMERICAN INSURANCE COMPANY | $280 | — | $280 | 0.04% |
| KENNETH JACKSON3 | 1111 W MORTON AVE SUITE 10 JACKSONVILLE, IL 62650 | CONTINENTAL AMERICAN INSURANCE COMPANY | $1 | — | $1 | 0.00% |
| DEVIN M PEGRAM3 | 1450 LENHART ROAD SPRINGFIELD, IL 62711 | CONTINENTAL AMERICAN INSURANCE COMPANY | $1 | — | $1 | 0.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 1411 OPUS PL STE 450 DOWNERS GROVE, IL 605151423 | VISION SERVICE PLAN | $6K | — | $6K | 3.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUECROSS BLUESHIELD OF ILLINOIS EIN 36-1236610 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | — | $1.6M |
| WEX EIN 01-0526993 CLAIMS PROCESSING | Claims processing Service code 12 | — | $30K |
| RXBENEFITS EIN 63-1157085 CLAIMS PROCESSING | Claims processing Service code 12 | — | $29K |
| HUB INTERNATIONAL MIDWEST LIMITED BROKER | Insurance agents and brokers Service code 22 | 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 | 2,006 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 14 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 2,020 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITEDHEALTHCARE INSURANCE COMPANY | 963 | $6.3M |
| Vision | VISION SERVICE PLAN | 1,445 | $207K |
| Life insurance | DEARBORN LIFE INSURANCE COMPANY | 2,006 | $2.7M |
| Short-term disability | DEARBORN LIFE INSURANCE COMPANY | 2,006 | $2.7M |
| Long-term disability | DEARBORN LIFE INSURANCE COMPANY | 2,006 | $2.7M |
| Prescription drug | UNITEDHEALTHCARE INSURANCE COMPANY | 963 | $6.3M |
| Other(2 contracts, 2 carriers) | DEARBORN LIFE INSURANCE COMPANY | 2,006 | $3.4M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,006 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.