| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 | 55 EAST JACKSON BLVD CHICAGO, IL 60604 | QUARTZ HEALTH BENEFIT PLANS CORPORATION | $16K | — | $16K | 1.61% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 15162 COLLECTION CENTER DR CHICAGO, IL 60603 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $15K | $9K | $24K | 17.30% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST LTD | 203 N LA SALLE ST FLOOR 20 CHICAGO, IL 606010000 | DELTA DENTAL OF WISCONSIN | $4K | — | $4K | 9.93% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST LTD | 203 N LA SALLE ST FLOOR 20 CHICAGO, IL 606010000 | WYSSTA INSURANCE COMPANY INC | $922 | — | $922 | 8.01% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST LTD | 203 N LA SALLE ST FLOOR 20 CHICAGO, IL 606010000 | DELTA DENTAL OF WISCONSIN | $468 | — | $468 | 9.90% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST LTD | 203 N LA SALLE ST FLOOR 20 CHICAGO, IL 60601 | WYSSTA INSURANCE COMPANY, INC. | $67 | — | $67 | 8.03% |
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 | 110 | 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) | 110 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental(2 contracts) | DELTA DENTAL OF WISCONSIN | 63 | $50K |
| Vision(2 contracts) | WYSSTA INSURANCE COMPANY INC | 58 | $12K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 108 | $139K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 108 | $139K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 108 | $139K |
| Prescription drug | QUARTZ HEALTH BENEFIT PLANS CORPORATION | 121 | $1.0M |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 108 | $139K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 121 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.