| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 | 375 BISHOPS WAY STE 224 BROOKFIELD, WI 53005 | UNITED HEALTHCARE INSURANCE COMPANY | $68K | — | $68K | 9.05% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL OF INDIANA LTD | PO BOX 158 EVANSVILLE, ID 47701 | UNITED HEALTHCARE INSURANCE COMPANY | $3K | — | $3K | 0.43% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL OF INDIANA LTD | 55 E JACKSON BLVD #14B CHICAGO, IL 60604 | UNITED HEALTHCARE INSURANCE COMPANY | $1K | — | $1K | 0.19% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 55 EAST JACKSON BOULEVARD SUITE 14A CHICAGO, IL 60604 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $137K | — | $137K | 19.68% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 15162 COLLECTIONS CENTER CHICAGO, IL 60693 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $25K | — | $25K | 3.54% |
| AXA ASSISTANCE, USA5 | 122 SOUTH MICHIGAN AVENUE SUITE 1100 CHICAGO, IL 60603 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $445 | $445 | 0.06% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH AND BENEFIT LLC | 1166 AVE OF AMERICAS NEW YORK, NY 10036 | FEDERAL INSURANCE COMPANY | — | — | $0 | — |
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 | 1,411 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 73 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,484 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | UNITED HEALTHCARE INSURANCE COMPANY | 1,411 | $769K |
| Dental(2 contracts, 2 carriers) | UNITED HEALTHCARE INSURANCE COMPANY | 1,421 | $803K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 3,592 | $694K |
| Short-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 3,592 | $694K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 3,592 | $694K |
| Prescription drug | UNITED HEALTHCARE INSURANCE COMPANY | 135 | $748K |
| Other(4 contracts, 4 carriers) | UNITED HEALTHCARE INSURANCE COMPANY | 3,592 | $1.5M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 3,592 | — |
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 compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.