| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| SBR SERVICES LLC3 | 2839 PACES FERRY RD SE STE 830 ATLANTA, GA 303395770 | SUN LIFE ASSURANCE COMPANY OF CANADA | $85K | — | $85K | 4.98% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | PO BOX 2158 RIVERSIDE, CA 92516 | SUN LIFE ASSURANCE COMPANY OF CANADA | — | $66K | $66K | 3.86% |
| UMR, INC.3 | 115 W WAUSAU AVE WAUSAU, WI 54401 | SUN LIFE ASSURANCE COMPANY OF CANADA | — | $8K | $8K | 0.50% |
| STEALTH PARTNER GROUP LLC3 | 18700 N HAYDEN ROAD SUITE 405 SCOTTSDALE, AZ 85255 | SUN LIFE ASSURANCE COMPANY OF CANADA | $513 | — | $513 | 0.03% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 55 E JACKSON BLVD CHICAGO, IL 606044466 | KAISER FOUNDATION HEALTH PLAN | $7K | — | $7K | 1.73% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 55 E JACKSON BLVD FL 14 CHICAGO, IL 606044466 | VISION SERVICE PLAN | $9K | — | $9K | 9.99% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 1411 OPUS PL STE 450 DOWNERS GROVE, IL 605151423 | VISION SERVICE PLAN | $3K | — | $3K | 3.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST LTD | 15162 COLLECTION CENTER DR CHICAGO, IL 60693 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $7K | — | $7K | 20.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST LTD | 15162 COLLECTION CENTER DR CHICAGO, IL 60693 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $2K | $2K | 5.01% |
| JAMES R NELLIGAN & ASSOCIATES LLC3 Filed as: JAMES R NELLIGAN AND ASSOCIATES LLC | 2338 IMMOKALEE RD STE 240 NAPLES, FL 34110 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $2K | $2K | 5.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST LTD | 15162 COLLECTION CENTER DR CHICAGO, IL 60693 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $7K | — | $7K | 20.00% |
| JAMES R NELLIGAN & ASSOCIATES LLC3 Filed as: JAMES R NELLIGAN AND ASSOCIATES LLC | 2338 IMMOKALEE RD STE 240 NAPLES, FL 34110 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $2K | $2K | 5.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST LTD | 15162 COLLECTION CENTER DR CHICAGO, IL 60693 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $2K | $2K | 4.32% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST | HUB INTL MIDWEST LIMITED OPERATING WEST ACCOUNT RIVERSIDE, CA 92516 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $3K | $3K | 69.51% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST | HUB INTL MIDWEST LIMITED OPERATION WEST ACCOUNT RIVERSIDE, CA 92516 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $347 | $347 | — |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST | HUB INTL MIDWEST LIMITED OPERATING WEST ACCOUNT RIVERSIDE, CA 92516 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $1K | $1K | — |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST | 55 E JACKSON BLVD 14TH FL STE 14A CHICAGO, IL 60604 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $3K | $3K | — |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST | HUB INTL MIDWEST LIMITED OPERATING WEST ACCOUNT RIVERSIDE, CA 92516 | CIGNA LIFE INSURANCE CO. OF NEW YORK | — | $77 | $77 | — |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UMR, INC. EIN 39-1995276 CLAIM PROCESSING | Claims processing Service code 12 | — | $407K |
| HUB INTERNATIAONAL MIDWEST LTD EIN 35-0672425 BROKER | Other commissions Service code 55 | ATTN ACCOUNTING 55 E JACKSON BLVD STE 14B CHICAGO, IL 60604 | $50K |
| DELTA DENTAL OF COLORADO EIN 84-0568337 NONE | Contract Administrator Service code 13 | — | $35K |
| RXBENEFITS, INC EIN 63-1157085 CLAIMS PROCESSING | Claims processing Service code 12 | — | $11K |
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 | 709 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 5 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 714 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN | 30 | $404K |
| Vision | VISION SERVICE PLAN | 560 | $93K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,035 | $5K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 877 | $0 |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 357 | $0 |
| Stop-loss / reinsurancereinsurance(2 contracts, 2 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 678 | $3.4M |
| Other(5 contracts, 3 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 1,035 | $78K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,035 | — |
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 compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.