| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 16253 COLLECTION CENTER DR 40 W MADISON 4TH FL BANK OF AMERICA CHICAGO, IL 60693 | METROPOLITAN LIFE INSURANCE COMPANY | — | $19K | $19K | 2.09% |
| STHEALTH BENEFIT SOLUTIONS LLC3 Filed as: STHEALTH BENEFIT SOLUTIONS, LLC | DBA STEALTH PARTNER GROUP 18940 N PIMA RD SUITE 210 SCOTTSDALE, AZ 85255 | SUNLIFE ASSURANCE COMPANY OF CANADA | $42K | — | $42K | 4.96% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SERVICE | 3390 UNIVERSITY AVE. #300 RIVERSIDE, CA 92501 | SUNLIFE ASSURANCE COMPANY OF CANADA | — | $22K | $22K | 2.55% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 16253 COLLECTION CENTER DR 40 W MADISON 4TH FL BANK OF AMERICA CHICAGO, IL 60693 | METROPOLITAN LIFE INSURANCE COMPANY | — | $14K | $14K | 2.43% |
| AMWINS3 | 50 WHITECAP DRIVE NORTH KINGSTOWN, RI 02852 | UNITED AMERICAN INS. CO. PRESCRIPTION DRUG PLAN | $9K | — | $9K | 5.47% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 55 E JACKSON BLVD CHICAGO, IL 60604 | UNITED AMERICAN INS. CO. PRESCRIPTION DRUG PLAN | $5K | — | $5K | 3.26% |
| AMWINS3 | 50 WHITECAP DRIVE NORTH KINGSTOWN, RI 02852 | UNITED AMERICAN INS. CO. MEDICAL SUPPLEMENT | $12K | — | $12K | 14.12% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 55 E JACKSON BLVD CHICAGO, IL 60604 | UNITED AMERICAN INS. CO. MEDICAL SUPPLEMENT | $3K | — | $3K | 3.53% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| AETNA LIFE INSURANCE COMPANY EIN 06-6033492 ADMINISTRATOR | Contract Administrator Service code 13 | 151 FARMINGTION AVENUE HARTFORD, CT 06156 | $2.8M |
| METROPOLITAN LIFE INSURANCE COMPANY EIN 13-5581829 ADMINISTRATOR | Claims processing; Contract Administrator Service code 12 | — | $372K |
| EMPATHIA INC EIN 39-1567366 EAP PROVIDER | Other services Service code 49 | N17W24100 RIVERWOOD DRIVE SUITE 300 WAUKESHA, WI 53188 | $184K |
| DELTA DENTAL OF WISCONSIN EIN 39-6094742 THIRD PARTY ADMIN. | Contract Administrator Service code 13 | — | $118K |
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 | 3,966 | 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) | 3,966 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITED AMERICAN INS. CO. MEDICAL SUPPLEMENT | 81 | $86K |
| Vision | VISION SERVICE PLAN | 2,897 | $505K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 6,003 | $899K |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 5,044 | $580K |
| Prescription drug | UNITED AMERICAN INS. CO. PRESCRIPTION DRUG PLAN | 76 | $157K |
| Stop-loss / reinsurancereinsurance | SUNLIFE ASSURANCE COMPANY OF CANADA | 3,108 | $851K |
| Other | METROPOLITAN LIFE INSURANCE COMPANY | 6,003 | $899K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 6,003 | — |
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.