| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 | 55 EAST JACKSON, 14TH FLOOR CHICAGO, IL 60604 | BLUECROSS BLUESHIELD OF ILLINOIS | $89K | $3K | $92K | 3.09% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MDWEST LTD | 3390 UNIVERSITY AVE., SUITE 300 RIVERSIDE, CA 92501 | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $25K | $4K | $29K | 38.97% |
| JAMES R NELLIGAN & ASSOCIATES LLC3 Filed as: JAMES R. NELLIGAN & ASSOCIATES | 1060 BROADWAY SUITE 400 ALBANY, NY 12204 | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $4K | — | $4K | 5.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 2120 PEWAUKEE ROAD SUITE 202 WAUKESHA, WI 53188 | HARTFORD LIFE AND ACCIDENT | $12K | $5K | $17K | 23.05% |
| JAMES R NELLIGAN & ASSOCIATES LLC3 Filed as: JAMES R NELLIGAN & ASSOCIATES | 1933 STATE ROUTE 35 STE 368 WALL, NJ 07719 | HARTFORD LIFE AND ACCIDENT | $4K | — | $4K | 5.00% |
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 | 221 | 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) | 221 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUESHIELD OF ILLINOIS | 463 | $3.0M |
| Dental | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 215 | $75K |
| Vision | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 215 | $75K |
| Life insurance(2 contracts, 2 carriers) | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 221 | $149K |
| Long-term disability(2 contracts, 2 carriers) | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 221 | $149K |
| Prescription drug | BLUECROSS BLUESHIELD OF ILLINOIS | 463 | $3.0M |
| Other(2 contracts, 2 carriers) | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 221 | $149K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 463 | — |
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.