| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 | 55 EAST JACKSON BOULEVARD CHICAGO, IL 60604 | BLUE CROSS BLUE SHIELD OF ILLINOIS | $36K | $4K | $40K | 2.17% |
| FOREST FINANCIAL GROUP INC3 Filed as: FOREST FINANCIAL GROUP INC. | 580 N BANK LANE SUITE 101 LAKE FOREST, IL 60045 | BLUE CROSS BLUE SHIELD OF ILLINOIS | $26K | $0 | $26K | 1.40% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST | 15162 COLLECTIONS CENTER CHICAGO, IL 60693 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $4K | $0 | $4K | 10.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST | 15162 COLLECTIONS CENTER CHICAGO, IL 60693 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | $0 | $3K | 10.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST | 15162 COLLECTIONS CENTER CHICAGO, IL 60693 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | $0 | $3K | 10.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST | 580 NORTH BANK LANE LAKE FOREST, IL 60045 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $6K | $0 | $6K | 24.37% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST LTD | 55 EAST JACKSON BOULEVAARD CHICAGO, IL 60604 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $2K | $908 | $3K | 12.54% |
| FOREST FINANCIAL GROUP INC3 Filed as: FOREST FINANCIAL GROUP, INC. | 580 N BANK LANE #101 LAKE FOREST, IL 60045 | EYEMED VISION CARE | $1K | $0 | $1K | 7.63% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 55 E. JACKSON CHICAGO, IL 60604 | EYEMED VISION CARE | $664 | $0 | $664 | 4.03% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST LTD | 55 E JACKSON BOULEVARD CHICAGO, IL 60604 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | $78 | $1K | 14.97% |
| CHRISTOPHER THOMAS SMITH3 | PO BOX 6650 METAIRIE, TN 70009 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $507 | $33 | $540 | 6.41% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST | 15162 COLLECTIONS CENTER CHICAGO, IL 60693 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $693 | $0 | $693 | 10.00% |
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 | 220 | 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) | 220 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF ILLINOIS | 308 | $1.8M |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 180 | $23K |
| Vision | EYEMED VISION CARE | 283 | $16K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 220 | $41K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 140 | $35K |
| Long-term disability(2 contracts) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 215 | $36K |
| Other(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 215 | $15K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 308 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.