| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 | 55 E JACKSON BLVD CHICAGO, IL 60604 | UNITED HEALTHCARE INSURANCE COMPANY | — | $174K | $174K | 4.20% |
| ASSUREDPARTNERS3 Filed as: ASSUREDPARTNERS NL LLC | 285 COZZINS STREET COLUMBUS, OH 43215 | UNITED HEALTHCARE INSURANCE COMPANY | — | -$34 | -$34 | -0.00% |
| AXION RMS LTD3 | 2651 WARRENVILLE ROAD, STE 200 DOWNERS GROVE, IL 60515 | UNITED HEALTHCARE INSURANCE COMPANY | — | -$208 | -$208 | -0.01% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST LTD | 55 E JACKSON BLVD CHICAGO, IL 60604 | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $13K | — | $13K | 7.49% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 15162 COLLECTION CENTER DR CHICAGO, IL 60693 | VISION SERVICE PLAN | $4K | — | $4K | 9.97% |
| AXION RMS LTD3 Filed as: AXION RMS LTD. | 2651 WARRENVILLE ROAD, STE. 200 DOWNERS GROVE, IL 60515 | HARTFORD LIFE AND ACCIDENT | -$88 | $8K | $8K | 21.70% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 55 E JACKSON STE. 14B CHICAGO, IL 60604 | HARTFORD LIFE AND ACCIDENT | $8K | — | $8K | 20.82% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| EB EMPLOYEE SOLUTIONS, LLC CONTRACT ADMINISTRATOR | Claims processing; Contract Administrator Service code 12 | 245 MAIN ST. SUITE 605 WHITE PLAINS, NY 10601 | $156K |
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 | 973 | 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) | 973 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITED HEALTHCARE INSURANCE COMPANY | 947 | $4.1M |
| Dental(2 contracts, 2 carriers) | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 973 | $303K |
| Vision | VISION SERVICE PLAN | 487 | $39K |
| Life insurance(2 contracts, 2 carriers) | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 998 | $211K |
| Short-term disability(2 contracts, 2 carriers) | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 998 | $211K |
| Long-term disability(2 contracts, 2 carriers) | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 998 | $211K |
| Other(2 contracts, 2 carriers) | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 998 | $211K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 998 | — |
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.
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.