| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 | 1205 CEDAR ROAD MOSINEE, WI 54455 | STANDARD INSURANCE COMPANY | $16K | $5K | $21K | 18.69% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 1202 CEDAR ROAD MOSINEE, WI 54455 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $6K | $7K | $13K | 24.30% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTL MIDWEST LTD DBA COMPASS IN | 1205 CEDAR ROAD MOSINEE, WI 54455 | WYSSTA INSURANCE COMPANY | $1K | — | $1K | 7.95% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UMR INC EIN 39-1995276 CLAIMS PROCESSOR | Claims processing Service code 12 | — | $46K |
| DELTA DENTAL OF WISCONSIN EIN 39-6094742 THIRD PARTY ADMINISTRATOR | Contract Administrator Service code 13 | — | $5K |
| HUB INTL MIDWEST DBA COMPASS INS BROKER | Insurance agents and brokers Service code 22 | — | $973 |
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 | 100 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 101 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITED HEALTHCARE INSURANCE COMPANY | 106 | $14K |
| Dental | WYSSTA INSURANCE COMPANY | 80 | $15K |
| Vision | WYSSTA INSURANCE COMPANY | 80 | $15K |
| Life insurance(2 contracts, 2 carriers) | STANDARD INSURANCE COMPANY | 136 | $164K |
| Short-term disability(2 contracts, 2 carriers) | STANDARD INSURANCE COMPANY | 136 | $164K |
| Long-term disability(2 contracts, 2 carriers) | STANDARD INSURANCE COMPANY | 136 | $164K |
| Other | BERKLEY LIFE | 106 | $523K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 136 | — |
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.