| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| FOREST FINANCIAL GROUP INC3 Filed as: FOREST FINANCIAL GROUP, INC. | 580 N BANK LANE SUITE 101 LAKE FOREST, IL 60045 | BCBS OF NEBRASKA | $36K | $45 | $37K | 4.12% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST | 580 N BANK LANE LAKE FOREST, IL 60045 | GUARDIAN | $3K | $3K | $6K | 15.45% |
| UNCO MIDLANDS, LLC3 | 1128 LINCOLN MALL , STE 200 LINCOLN, NE 68508 | GUARDIAN | $743 | — | $743 | 1.82% |
| MARK PIETSCH3 | 1751 LAKE COOK ROAD DEERFIELD, IL 60015 | GUARDIAN | $33 | — | $33 | 0.08% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST, LTD | 55 E JACKSON BLVD CHICAGO, IL 60604 | UNUM LIFE INSURANCE CO | $2K | $72 | $2K | 15.61% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST, LTD | EMPLOYEE BENEFITS DEPT 55 JACKSON BLVD, #14A CHICAGO, IL 60604 | UNUM LIFE INSURANCE CO | — | $16 | $16 | 0.14% |
| UNICO MIDLANDS LLC3 Filed as: UNICO MIDLANDS, LLC | 1128 LINCOLN MALL #200 LINCOLN, NE 68508 | EYEMED VISION CARE | $321 | — | $321 | 3.44% |
| FOREST FINANCIAL GROUP INC3 Filed as: FOREST FINANCIAL GROUP, INC. | 580 N BANK LANE, STE 101 LAKE FOREST, IL 60045 | EYEMED VISION CARE | $319 | — | $319 | 3.42% |
| UNICO MIDLANDS LLC3 Filed as: UNICO MIDLANDS, LLC 16019135 | 1128 LINCOLN MALL #200 LINCOLN, NE 68508 | EYEMED VISION CARE | $130 | — | $130 | 1.39% |
| UNICO GROUP INC3 Filed as: UNICO GROUP, LLC | 1125 LINCOLN MALL, STE 200 LINCOLN, NE 68508 | PROVIDENT LIFE AND ACCIDENT INS CO | $153 | — | $153 | 1.83% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST, LTD | 55 E JACSKSON BLVD CHICAGO, IL 60604 | PROVIDENT LIFE AND ACCIDENT INS CO | $21 | — | $21 | 0.25% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST, LTD | 55 E JACKSON BLVD CHICAGO, IL 60604 | UNUM LIFE INSURANCE CO | $463 | $28 | $491 | 10.60% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST, LTD | EMPLOYEE BENEFITS DEPT 55 E JACKSON BLVD, # 14A CHICAGO, IL 60604 | UNUM LIFE INSURANCE CO | — | $6 | $6 | 0.13% |
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 | 185 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Beneficiaries receiving benefits | 0 | Spouses or dependents with eligibility independent of the participant. |
| Total participants (= "Plan participants" tile) | 186 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BCBS OF NEBRASKA | 152 | $885K |
| Dental | GUARDIAN | 87 | $41K |
| Vision | EYEMED VISION CARE | 124 | $9K |
| Life insurance | UNUM LIFE INSURANCE CO | 185 | $5K |
| Long-term disability | UNUM LIFE INSURANCE CO | 25 | $12K |
| Other(2 contracts, 2 carriers) | PROVIDENT LIFE AND ACCIDENT INS CO | 185 | $13K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 185 | — |
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.