| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 | 55 E. JACKSON BLVD. 14TH FLOOR A CHICAGO, IL 60604 | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | $0 | $7K | $7K | 1.69% |
| AON CONSULTING INC3 Filed as: AON CONSULTING | 29840 NETWORK PLACE CHICAGO, IL 606731296 | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | $0 | $2K | $2K | 0.44% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CVS PHARMACY, INC. EIN 05-0340626 NONE | Claims processing; Contract Administrator Service code 12 | — | $4.3M |
| BLUECROSS BLUESHIELD OF ILLINOIS EIN 36-1236610 NONE | Contract Administrator; Claims processing Service code 12 | — | $542K |
| LIBERTY LIFE ASSURANCE COMPANY OF B EIN 04-6076039 NONE | Claims processing; Contract Administrator Service code 12 | — | $78K |
| CIGNA HEALTH & LIFE INSURANCE CO. EIN 59-1031071 NONE | Float revenue; Non-monetary compensation; Direct payment from the plan; Named fiduciary; Participant communication; Contract Administrator; Other services; Claims processing Service code 12 | — | $42K |
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 | 1,058 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 169 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,227 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | VISION SERVICE PLAN | 780 | $176K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,058 | $715K |
| Long-term disability | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | 1,705 | $426K |
| Other(2 contracts) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,058 | $789K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,705 | — |
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."
Broker comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.