| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 | 1411 OPUS PLACE, SUITE 450 DOWNER GROVE, IL 60515 | UNITEDHEALTHCARE INSURANCE COMPANY | $16K | $0 | $16K | 1.18% |
| WILLIS TOWERS WATSON US LLC Filed as: WILLIS OF WISCONSIN, INC. | 400 NORTH EXECUTIVE DRIVE SUITE 400 BROOKFIELD, WI 53005 | UNITEDHEALTHCARE INSURANCE COMPANY | $14K | $0 | $14K | 1.03% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 55 EAST JACKSON BOULEVARD 14TH FLOOR CHICAGO, IL 60604 | QUARTZ HEALTH BENEFIT PLANS CORPORATION | $6K | $0 | $6K | 2.68% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST LTD | 15161 COLLECTION CENTER DRIVE CHICAGO, IL 60693 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $3K | $0 | $3K | 15.00% |
| THE JAMES B OSWALD COMPANY3 Filed as: JAMES R. NELLIGAN AND ASSOC. LLC | 1800 ROUTE 34 BUILDING 4, SUITE 404A WALL, NJ 07719 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $403 | $0 | $403 | 1.92% |
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 | 114 | 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) | 114 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | UNITEDHEALTHCARE INSURANCE COMPANY | 181 | $1.5M |
| Vision | UNITEDHEALTHCARE INSURANCE COMPANY | 181 | $1.3M |
| Life insurance | RELIANCE STANDARD LIFE INSURANCE COMPANY | 114 | $21K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 114 | $21K |
| Prescription drug(2 contracts, 2 carriers) | UNITEDHEALTHCARE INSURANCE COMPANY | 181 | $1.5M |
| Other | RELIANCE STANDARD LIFE INSURANCE COMPANY | 114 | $21K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 181 | — |
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.