| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 | 55 E JACKSON BLVD CHICAGO, IL 60604 | SUN LIFE ASSURANCE COMPANY OF CANADA | $784 | — | $784 | 1.03% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST LTD D/B/A | THE MURPHY INSURANCE GROUP 15162 COLLECTION CENTER DR CHICAGO, IA 60693 | SUN LIFE ASSURANCE COMPANY OF CANADA | -$1K | — | -$1K | -1.34% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST LTD | 55 E JACKSON BLVD #14A CHICAGO, IL 60604 | DELTA DENTAL OF WISCONSIN | $452 | — | $452 | 1.16% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UMR, INC EIN 39-1995276 CLAIM PROCESSING | Claims processing Service code 12 | — | $46K |
| OPTUMRX, INC EIN 33-0441200 PHARMACY BENEFIT MGMT | Direct payment from the plan; Claims processing; Other fees; Float revenue Service code 12 | — | $4K |
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 | 195 | 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) | 195 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HUMANA INSURANCE COMPANY | 86 | $119K |
| Dental | DELTA DENTAL OF WISCONSIN | 116 | $39K |
| Vision | WYSSTA INSURANCE COMPANY, INC. | 72 | $9K |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 187 | $76K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 187 | $76K |
| Stop-loss / reinsurancereinsurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 86 | $525K |
| Other | SUN LIFE ASSURANCE COMPANY OF CANADA | 187 | $76K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 187 | — |
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.