| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 | EMPLOYEE BENEFITS DEPARTMENT, CHICAGO, IL 60604 | AETNA LIFE INSURANCE COMPANY | $18K | $0 | $18K | 10.65% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| AETNA LIFE INSURANCE CO EIN 06-6033492 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | 151 FARMINGTON AVE HARTFORD, CT 06156 | $812K |
| UMR, INC. EIN 39-1995276 CLAIMS PROCESSOR | Claims processing Service code 12 | 5151 PFEIFFER ROAD CINCINNATI, OH 45242 | $481K |
| PRUDENTIAL INSURANCE COMPANY OF AME EIN 22-1211670 | Contract Administrator Service code 13 | — | $349K |
| EXPRESS SCRIPTS ASO NONE | Claims processing Service code 12 | ONE EXPRESS WAY ST. LOUIS, MI 63121 | $329K |
| DELTA DENTAL OF WISCONSIN EIN 39-6094742 THIRD PARTY ADMINISTRATOR | Contract Administrator Service code 13 | 400 N EXECUTIVE DR STE 300 BROOKFIELD, WI 53005 | $100K |
| TELADOC, INC. | Other services Service code 49 | 4100 SPRING VALLEY, SUITE 600 DALLAS, TX 75244 | $71K |
| BENEFIT ADVANTAGE NONE | Claims processing Service code 12 | 3431 COMMODITY LANE GREEN BAY, WI 53404 | $60K |
| WILLIS TOWERS WATSON US LLC EIN 53-0181291 BROKER | Other commissions Service code 55 | PO BOX 28852 NEW YORK, NY 10087 | $56K |
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 | 10,969 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 99 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 11,068 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | BLUECROSS BLUESHIELD OF ILLINOIS | 5,936 | $24.0M |
| Dental(12 contracts, 3 carriers) | CARE PLUS DENTAL PLANS, INC. | 409 | $790K |
| Vision(3 contracts, 2 carriers) | EYEMED VISION CARE | 8,660 | $803K |
| Life insurance | PRUDENTIAL | 5,286 | $839K |
| Long-term disability | PRUDENTIAL | 3,026 | $887K |
| Other(6 contracts, 2 carriers) | PRUDENTIAL | 10,969 | $1.5M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 10,969 | — |
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.
Broker comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.