| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTENATIONAL MIDWEST | 55 E. JACKSON BLVD, 14A CHICAGO, IL 60604 | BLUECROSS BLUESHIELD OF ILLINOIS | $45K | $2K | $48K | 3.44% |
| ASSURANCE AGENCY LTD3 Filed as: ASSURANCE AGENCY, LTD | 1750 E GOLF RD, STE 140 CHICAGO, IL 60173 | BLUECROSS BLUESHIELD OF ILLINOIS | $9K | — | $9K | 0.62% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 55 E JACKSON BLVD CHICAGO, IL 60604 | METROPOLITAN LIFE INSURANCE COMPANY | $2K | — | $2K | 1.80% |
| ASSURANCE AGENCY LTD3 Filed as: ASSURANCE AGENCY | 1750 E GOLF RD SCHAUMBURG, IL 60173 | METROPOLITAN LIFE INSURANCE COMPANY | $2K | $35 | $2K | 1.74% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 16253 COLLECTION CENTER DR CHICAGO, IL 60693 | METROPOLITAN LIFE INSURANCE COMPANY | — | $1K | $1K | 1.07% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST | 55 E JACKSON BLVD, 14A CHICAGO, IL 60604 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $296 | $3K | 8.89% |
| ASSURANCE AGENCY LTD3 Filed as: ASSURANCE AGENCY | 1750 E GOLF RD SCHAUMBURG, IL 60173 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | $199 | $2K | 4.92% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 15162 COLLECTION CENTER DR CHICAGO, IL 60693 | VISION SERVICE PLAN | $582 | — | $582 | 3.36% |
| ASSURANCE AGENCY LTD3 Filed as: ASSURANCE AGENCY, LTD | 1750 E GOLF RD, STE 140 CHICAGO, IL 60173 | VISION SERVICE PLAN | $421 | — | $421 | 2.43% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST | 55 E JACKSON BLVD, 14A CHICAGO, IL 60604 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $871 | $116 | $987 | 8.13% |
| ASSURANCE AGENCY LTD3 Filed as: ASSURANCE AGENCY | 1750 E GOLF ROAD SCHAUMBURG, IL 60173 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $899 | $75 | $974 | 8.02% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 55 E JACKSON BLVD, 12TH FL CHICAGO, IL 60604 | DEARBORN NATIONAL LIFE INSURANCE COMPANY | $303 | — | $303 | 3.86% |
| ASSURANCE AGENCY LTD3 Filed as: ASSURANCE AGENCY, LTD | 1750 E GOLF RD, STE 1100 SCHAUMBURG, IL 60173 | DEARBORN NATIONAL LIFE INSURANCE COMPANY | $202 | — | $202 | 2.57% |
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 | 124 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Beneficiaries receiving benefits | 0 | Spouses or dependents with eligibility independent of the participant. |
| Total participants (= "Plan participants" tile) | 125 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUESHIELD OF ILLINOIS | 239 | $1.4M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 371 | $96K |
| Vision | VISION SERVICE PLAN | 122 | $17K |
| Life insurance | DEARBORN NATIONAL LIFE INSURANCE COMPANY | 122 | $8K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 128 | $31K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 128 | $31K |
| Other(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 122 | $20K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 371 | — |
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.