| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 375 BISHOPS WAY BROOKFIELD, WI 53005 | UNITED HEALTHCARE INSURANCE COMPANY | $5K | $36K | $41K | 3.26% |
| CSIG INSURANCE AGENCY3 | 126 N. JEFFERSON STREET MILWAUKEE, WI 53202 | UNITED HEALTHCARE INSURANCE COMPANY | $1K | $12K | $13K | 1.01% |
| FST ASSOCIATES INC3 Filed as: FST ASSOCIATES, INC. | 55 W. MONROE STREET CHICAGO, IL 60603 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $925 | $2K | $3K | 6.02% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 15162 COLLECTION CENTER DRIVE CHICAGO, IL 60693 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | — | $3K | 5.78% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 15162 COLLECTION CENTER DRIVE CHICAGO, IL 60603 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | — | $3K | 7.84% |
| FST ASSOCIATES INC3 Filed as: FST ASSOCIATES, INC. | 55 W. MONROE STREET CHICAGO, IL 60603 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $933 | $2K | $3K | 6.90% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 15162 COLLECTION CENTER DRIVE CHICAGO, IL 60693 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $621 | — | $621 | 8.31% |
| FST ASSOCIATES INC3 Filed as: FST ASSOCIATES, INC. | 55 W. MONROE STREET CHICAGO, IL 60603 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $126 | $348 | $474 | 6.34% |
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 | 182 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 29 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 211 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITED HEALTHCARE INSURANCE COMPANY | 362 | $1.3M |
| Dental | UNITED HEALTHCARE INSURANCE COMPANY | 362 | $1.3M |
| Vision | UNITED HEALTHCARE INSURANCE COMPANY | 362 | $1.3M |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 182 | $7K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 182 | $56K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 182 | $37K |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 182 | $7K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 362 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.