| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 | 2120 PEWAUKEE ROAD, SUITE 202 WAUKESHA, WI 53188 | BLUE CROSS BLUE SHIELD OF WISCONSIN | $33K | $0 | $33K | 3.94% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 2120 PEWAUKEE ROAD, SUITE 202 WAUKESHA, WI 53188 | DELTA DENTAL OF WISCONSIN | $4K | $0 | $4K | 9.94% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 2120 PEWAUKEE ROAD, SUITE 202 WAUKESHA, WI 53188 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4K | $214 | $4K | 14.89% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 2120 PEWAUKEE ROAD, SUITE 202 WAUKESHA, WI 53188 | WYSSTA INSURANCE COMPANY INC | $636 | $0 | $636 | 8.05% |
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 | 167 | 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) | 167 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF WISCONSIN | 160 | $827K |
| Dental | DELTA DENTAL OF WISCONSIN | 100 | $43K |
| Vision | WYSSTA INSURANCE COMPANY INC | 83 | $8K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 167 | $29K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF WISCONSIN | 160 | $827K |
| Other | UNUM LIFE INSURANCE COMPANY OF AMERICA | 167 | $29K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 167 | — |
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.