| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 | 55 EAST JACKSON BOULEVARD CHICAGO, IL 60604 | BLUE CROSS BLUE SHIELD | — | $21K | $21K | 0.15% |
| STHEALTH BENEFIT SOLUTIONS LLC3 | 18940 N PIMA RD, STE 210 SCOTTSDALE, AZ 85255 | SUN LIFE ASSURANCE COMPANY OF CANADA | $55K | — | $55K | 4.90% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 55 E JACKSON BLVD CHICAGO, IL 60604 | SUN LIFE ASSURANCE COMPANY OF CANADA | — | $43K | $43K | 3.86% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 55 E. JACKSON BOULEVARD 14TH FLOOR A CHICAGO, IL 60604 | LINCOLN LIFE ASSURANCE COMPANY OF BOSTON | — | $10K | $10K | 0.94% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 55 E. JACKSON BOULEVARD 1475 FLOOR A CHICAGO, IL 60604 | LINCOLN LIFE ASSURANCE COMPANY OF BOSTON | — | $7K | $7K | 0.93% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 55 E JAKSON BLVD FL 14 CHICAGO, IL 606044466 | METROPOLITAN LIFE INSURANCE COMPANY | $438 | $54 | $492 | 0.24% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 16253 COLLECTION CENTER DR 40 W MADISON 4TH FL BOA LOCK BOX SVCS CHICAGO, IL 606930162 | METROPOLITAN LIFE INSURANCE COMPANY | — | $70 | $70 | 0.03% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 55 E JACKSON BLVD, FL 14 CHICAGO, IL 606044466 | SAFEGUARD HEALTH PLANS, INC. A CALIFORNIA CORPORATION | $381 | — | $381 | 8.20% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 16253 COLLECTION CENTER DR 40 W MADISON FL 4 BOA LOCK BOX SVCS CHICAGO, IL 606930162 | SAFEGUARD HEALTH PLANS, INC. A CALIFORNIA CORPORATION | — | $62 | $62 | 1.33% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 55 E JACKSON BLVD FL 14 CHICAGO, IL 606044466 | SAFEGUARD HEALTH PLANS, INC., A FLORIDA CORPORATION | $215 | — | $215 | 7.65% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 16253 COLLECTION CENTER DR 40 W MADISON 4TH FL BOA LOCK BOX SVCS CHICAGO, IL 606930162 | SAFEGUARD HEALTH PLANS, INC., A FLORIDA CORPORATION | — | $34 | $34 | 1.21% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 55 E JACKSON BLVD FL 14 CHICAGO, IL 606044466 | SAFEGUARD HEALTH PLANS, INC., A TEXAS CORPORATION | $138 | — | $138 | 7.08% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 16253 COLLECTION CENTER DR 40 W MADISON 4TH BOA LOCK BOX SCVS CHICAGO, IL 606930162 | SAFEGUARD HEALTH PLANS, INC., A TEXAS CORPORATION | — | $22 | $22 | 1.13% |
| REUBEN WARNER ASSOCIATES, INC.3 | 1655 RICHMOND AVENUE STATEN ISLAND, NY 10314 | FEDERAL INSURANCE COMPANY | — | — | $0 | — |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES - CHICAGO | 500 WEST MONROE STREET CHICAGO, IL 60661 | FEDERAL INSURANCE COMPANY | — | — | $0 | — |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| METROPOLITAN LIFE INSURANCE COMPANY EIN 13-5581829 SERVICE PROVIDER | Claims processing; Contract Administrator Service code 12 | — | $66K |
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 | 2,090 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 34 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 2,124 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD | 3,112 | $14.0M |
| Dental(4 contracts, 4 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 2,670 | $214K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 2,670 | $204K |
| Life insurance | LINCOLN LIFE ASSURANCE COMPANY OF BOSTON | 1,961 | $1.0M |
| Long-term disability | LINCOLN LIFE ASSURANCE COMPANY OF BOSTON | 1,961 | $728K |
| Other(2 contracts, 2 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 2,090 | $1.1M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 3,112 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.