| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 | 55 EAST JACKSON BOULEVARD CHICAGO, IL 60604 | BLUE CROSS BLUE SHIELD | — | $23K | $23K | 0.14% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 55 E. JACKSON BOULEVARD 14TH FLOOR A CHICAGO, IL 60604 | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | — | $16K | $16K | 1.13% |
| FST ASSOCIATES INC3 Filed as: FST ASSOCIATED DBA LAURUS STRATEGIE | 55 W. MONROE, SUITE 500 CHICAGO, IL 60603 | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | — | $10K | $10K | 0.69% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 55 E. JACKSON BOULEVARD 1475 FLOOR A CHICAGO, IL 60604 | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | — | $12K | $12K | 1.13% |
| FST ASSOCIATES INC3 Filed as: FST ASSOCIATED DBA LAURUS STRATEGIE | 55 W. MONROE, SUITE 500 CHICAGO, IL 60603 | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | — | $7K | $7K | 0.71% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 55 E. JACKSON BOULEVARD 14TH FLOOR A CHICAGO, IL 60604 | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | — | $752 | $752 | 2.38% |
| FST ASSOCIATES INC3 Filed as: FST ASSOCIATED DBA LAURUS STRATEGIE | 55 W. MONROE, SUITE 500 CHICAGO, IL 60603 | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | — | $455 | $455 | 1.44% |
| REUBEN WARNER ASSOCIATES, INC.3 | 1655 RICHMOND AVENUE STATEN ISLAND, NY 10314 | FEDERAL INSURANCE COMPANY | $653 | — | $653 | 20.01% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES - CHICAGO | 500 WEST MONROE STREET CHICAGO, IL 60661 | FEDERAL INSURANCE COMPANY | $489 | — | $489 | 14.99% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| LIBERTY LIFE ASSURANCE COMPANY OF B EIN 04-6076039 SERVICE PROVIDER | Contract Administrator; Claims processing; Insurance services Service code 12 | — | $58K |
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 | 2,662 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 60 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 2,722 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD | 4,210 | $19.4M |
| Dental | DELTA DENTAL | 2,197 | $80K |
| Vision | VISION SERVICE PLAN | 1,928 | $222K |
| Life insurance | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | 2,248 | $1.4M |
| Long-term disability | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | 2,248 | $1.0M |
| Prescription drug | WELLMARK BCBS OF SOUTH DAKOTA | 206 | $2.5M |
| Stop-loss / reinsurancereinsurance | BLUE CROSS BLUE SHIELD | 4,210 | $16.9M |
| Other(4 contracts, 3 carriers) | WELLMARK BCBS OF SOUTH DAKOTA | 2,662 | $4.0M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 4,210 | — |
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."
Broker comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.