| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF NEW YORK, INC. | ONE WORLD FINANCIAL 200 LIBERTY STREET NEW YORK, NY 10281 | GERBER LIFE | $63K | — | $63K | 9.10% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF NEW YORK INC. | ONE WORLD FINANCIAL CENTER 200 LIBERTY ST NEW YORK, NY 10281 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | — | $3K | 2.88% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 55 E JACKSON BLVD 14TH FL CHICAGO, IL 60604 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $480 | — | $480 | 0.49% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF NEW YORK INC. | ONE WORLD FINANCIAL CENTER 200 LIBERTY ST NEW YORK, NY 10281 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | — | $2K | 2.53% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 55 E JACKSON BLVD 14TH FL CHICAGO, IL 60604 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $623 | — | $623 | 0.76% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF NEW YORK INC. | ONE WORLD FINANCIAL CENTER 200 LIBERTY ST NEW YORK, NY 10281 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | — | $3K | 5.64% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 55 E JACKSON BLVD 14TH FL CHICAGO, IL 60604 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | — | $1K | 2.15% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 15162 COLLECTION CENTER DRIVE CHICAGO, IL 606930001 | VISION SERVICE PLAN | $1K | — | $1K | 2.91% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF NEW YORK, INC. | ONE WORLD FINANCIAL CENTER 200 LIBERTY ST NEW YORK, NY 10281 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $442 | — | $442 | 5.52% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 55 E JACKSON BLVD 14TH FL CHICAGO, IL 60604 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $442 | — | $442 | 5.52% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF NEW YORK, INC. | ONE WORLD FINANCIAL CENTER 200 LIBERTY STREET NEW YORK, NY 10281 | LIFE INSURANCE CO. OF NEW YORK | $72 | — | $72 | 4.40% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 55 E JACKSON BLVD, 14TH FL CHICAGO, IL 60604 | LIFE INSURANCE CO. OF NEW YORK | $64 | — | $64 | 3.91% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF NEW YORK, INC. | ONE WORLD FINANCIAL CENTER 200 LIBERTY STREET NEW YORK, NY 10281 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $28 | — | $28 | 5.02% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 55 E JACKSON BLVD 14TH FL CHICAGO, IL 60604 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $24 | — | $24 | 4.30% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| OPTUMRX, INC. EIN 33-0441200 PHARMACY BENEFIT MGMT | Direct payment from the plan; Claims processing; Other fees; Float revenue Service code 12 | — | $1.1M |
| UMR, INC. EIN 39-1995276 CLAIM PROCESSING | Claims processing Service code 12 | — | $225K |
| WILLIS OF NEW YORK, INC. EIN 13-2695427 BROKER | Other commissions Service code 55 | ONE WORLD FINANCIAL 200 LIBERTY STREET NEW YORK, NY 10281 | $31K |
| HUB INTERNATIONAL MIDWEST LTD EIN 35-0672425 BROKER | Other commissions Service code 55 | 55 E JACKSON BLVD, STE. 14B CHICAGO, IL 60604 | $3K |
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 | 890 | 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) | 890 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | VISION SERVICE PLAN | 436 | $45K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 896 | $98K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 767 | $82K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 410 | $49K |
| Stop-loss / reinsurancereinsurance | GERBER LIFE | 445 | $696K |
| Other(4 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 896 | $108K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 896 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.