| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 | 1411 OPUS PL STE 450 DOWNERS GROVE, IL 605151423 | UNITEDHEALTHCARE INSURANCE COMPANY | — | $187K | $187K | 3.18% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST LTD | 55 E JACKSON BLVD CHICAGO, IL 60604 | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $24K | $7K | $31K | 8.54% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 15162 COLLECTION CENTER DR CHICAGO, IL 60693 | VISION SERVICE PLAN | $4K | — | $4K | 9.36% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BUSINESSOLVER CONTRACT ADMINISTRATOR | Claims processing; Contract Administrator Service code 12 | 1025 ASHWORTH ROAD, STE 101 WEST DES MOINES, IA 50265 | $12K |
| DEPENDENT SPECIALISTS, INC. CONTRACT ADMINISTRATOR | Contract Administrator; Claims processing Service code 12 | PO BOX 80133 RANCHO SANTA MARGARITA, CA 92688 | $11K |
| PAYLOCITY CONTRACT ADMINISTRATOR | Contract Administrator; Claims processing Service code 12 | 1400 AMERICAN LANE SCHAUMBURG, IL 60173 | $7K |
| TASC CONTRACT ADMINISTRATOR | Claims processing; Contract Administrator Service code 12 | 2302 INTERNATIONAL LANE MADISON, WI 537043140 | $1K |
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 | 1,015 | 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) | 1,015 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITEDHEALTHCARE INSURANCE COMPANY | 582 | $5.9M |
| Dental | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 1,015 | $366K |
| Vision | VISION SERVICE PLAN | 572 | $43K |
| Life insurance | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 1,015 | $366K |
| Short-term disability | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 1,015 | $366K |
| Long-term disability | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 1,015 | $366K |
| Other | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 1,015 | $366K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,015 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
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.