| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 | 2120 PEWAUKEE RD. SUITE 202 WAUKESHA, WI 53188 | ANTHEM BLUE CROSS AND BLUE SHIELD | $53K | $2K | $55K | 3.35% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SERVICE | PO BOX 4047 CONCORD, CA 94524 | ANTHEM BLUE CROSS AND BLUE SHIELD | — | $1K | $1K | 0.08% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 2120 PEWAUKEE ROAD, SUITE 202 WAUKESHA, WI 53188 | UNITED HEALTHCARE INSURANCE COMPANY | $10K | — | $10K | 26.35% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST, LTD | 15162 COLLECTIONS CENTER DRIVE CHICAGO, IL 60693 | CARE-PLUS DENTAL PLANS. INC. | $1K | — | $1K | 8.00% |
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 | 125 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 125 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | ANTHEM BLUE CROSS AND BLUE SHIELD | 51 | $1.7M |
| Dental(2 contracts, 2 carriers) | ANTHEM BLUE CROSS AND BLUE SHIELD | 73 | $1.7M |
| Vision | ANTHEM BLUE CROSS AND BLUE SHIELD | 0 | $1.6M |
| Life insurance | ANTHEM LIFE INSURANCE COMPANY | 0 | $144K |
| Long-term disability | ANTHEM LIFE INSURANCE COMPANY | 0 | $144K |
| Other(2 contracts, 2 carriers) | ANTHEM LIFE INSURANCE COMPANY | 51 | $182K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 73 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.