| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 | PO BOX 2158 RIVERSIDE, CA 92506 | BLUECROSS BLUESHIELD OF ILLINOIS | $47K | — | $47K | 3.97% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 55 EAST JACKSON BLVD CHICAGO, IL 60604 | NATIONWIDE | $16K | — | $16K | 5.19% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 55 EAST JACKSON BLVD CHICAGO, IL 60604 | AMERITAS | $4K | — | $4K | 10.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 55 EAST JACKSON BLVD CHICAGO, IL 60604 | KAISER FOUNDATION HEALTH PLAN, INC. | $905 | — | $905 | 2.80% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| FRINGE BENEFIT GROUP, INC. EIN 74-2124394 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | 11910 ANDERSON MILL RD AUSTIN, TX 78726 | $221K |
| HUB INTERNATIONAL MIDWEST LIMITED EIN 35-0672425 BROKER | Other commissions Service code 55 | 55 EAST JACKSON BLVD CHICAGO, IL 60604 | $122K |
| FIRST HEALTH EIN 20-1736437 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | 3200 HIGHLAND AVE DOWNERS GROVE, IL 60515 | $38K |
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 | 943 | 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) | 943 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUECROSS BLUESHIELD OF ILLINOIS | 717 | $1.5M |
| Dental | AMERITAS | 453 | $42K |
| Vision | AMERITAS | 453 | $42K |
| Life insurance | NATIONWIDE | 717 | $314K |
| Prescription drug(2 contracts, 2 carriers) | BLUECROSS BLUESHIELD OF ILLINOIS | 153 | $1.2M |
| Stop-loss / reinsurancereinsurance | NATIONWIDE | 717 | $314K |
| Other | NATIONWIDE | 717 | $314K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 717 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.