| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| SBR SERVICES LLC3 | 2839 PACES FERRY ROAD SE SUITE 830 ATLANTA, GA 30339 | HCC LIFE INSURANCE COMPANY | — | $5K | $5K | 3.00% |
| 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 | — | $5K | $5K | 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 | $3K | — | $3K | 3.43% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST LTD | 15162 COLLECTION CENTER DR CHICAGO, IL 60693 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $3K | $3K | 3.13% |
| 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 | 10.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST LTD | 15162 COLLECTION CENTER DR CHICAGO, IL 60693 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $5K | $5K | 6.98% |
| 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 | — | $4K | $4K | 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 | $10K | — | $10K | 15.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 15162 COLLECTION CENTER DR CHICAGO, IL 60693 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $5K | $5K | 7.04% |
| JAMES R NELLIGAN & ASSOCIATES LLC3 Filed as: JAMES R NELLIGAN AND ASSOCIATES | 2338 IMMOKALEE RD STE 240 NAPLES, FL 34110 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $3K | $3K | 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 | $4K | — | $4K | 10.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST LTD | 15162 COLLECTION CENTER DR CHICAGO, IL 60693 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $3K | $3K | 6.77% |
| JAMES R NELLIGAN & ASSOCIATES LLC3 Filed as: JAMES R NELLIGAN AND ASSOCATES LLC | 2338 IMMOKALEE RD STE 240 NAPLES, FL 34110 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $2K | $2K | 5.00% |
| SBR SERVICES LLC3 | 2839 PACES FERRY ROAD SE SUITE 830 ATLANTA, GA 30339 | HCC LIFE INSURANCE COMPANY | — | $1K | $1K | 3.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 55 E JACKSON BLVD FL 14 CHICAGO, IL 606044466 | VISION SERVICE PLAN | $867 | — | $867 | 3.30% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 1411 OPUS PL STE 450 DOWNERS GROVE, IL 605151423 | VISION SERVICE PLAN | $667 | — | $667 | 2.54% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 55 E JACKSON BLVD CHICAGO, IL 60604 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $820 | — | $820 | 8.29% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES INC. | PO BOX 896620 CHARLOTTE, NC 282217196 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $333 | — | $333 | 3.37% |
| THE BENEFIT COMPANY INC3 | PO BOX 211486 COLUMBIA, SC 29221 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $333 | — | $333 | 3.37% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 55 E JACKSON BLVD CHICAGO, IL 60604 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $857 | — | $857 | 9.65% |
| THE BENEFIT COMPANY INC3 | PO BOX 211486 COLUMBIA, SC 29221 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $229 | — | $229 | 2.58% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INS SVCS INC | PO BOX 896620 CHARLOTTE, NC 282171964 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $217 | — | $217 | 2.44% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 55 E JACKSON BLVD CHICAGO, IL 60604 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $739 | — | $739 | 10.14% |
| THE BENEFIT COMPANY INC3 | PO BOX 211486 COLUMBIA, SC 29221 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $237 | — | $237 | 3.25% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INS SVCS INC | PO BOX 896620 CHARLOTTE, NC 282171964 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $236 | — | $236 | 3.24% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONALL MIDWEST LIMITED | 55 E JACKSON BLVD CHICAGO, IL 60604 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $270 | — | $270 | 4.61% |
| THE BENEFIT COMPANY INC3 | PO BOX 211486 COLUMBIA, SC 29221 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $230 | — | $230 | 3.93% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INS SVCS INC | PO BOX 896620 CHARLOTTE, NC 282171964 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $174 | — | $174 | 2.97% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UMR, INC. EIN 39-1995276 CLAIMS PROCESSING | Claims processing Service code 12 | — | $117K |
| HUB INTERNATIONAL MIDWEST LTD EIN 35-0672425 BROKER | Other commissions Service code 55 | 15162 COLLECTION CENTER DR 55 E JACKSON BLVD STE 14B CHICAGO, IL 60693 | $17K |
| UNITED OF OMAHA LIFE INS COMPANY EIN 47-0322111 CONTRACT ADMINISTRATOR | Claims processing; Contract Administrator Service code 12 | — | $12K |
| RXBENEFITS, INC EIN 63-1157085 NONE | Claims processing Service code 12 | — | $2K |
| JAMES R NELLIGAN AND ASSOCIATES BROKER | Other commissions Service code 55 | 2338 IMMOKALEE RD STE 240 NAPLES, FL 34110 | $0 |
| UNITED OF OHAHA LIFE INS CO BROKER | Other commissions Service code 55 | MUTUAL OF OMAHA PLAZA OMAHA, NE 68175 | $0 |
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 | 209 | 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) | 214 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts) | HCC LIFE INSURANCE COMPANY | 184 | $220K |
| Dental | UNITED OF OMAHA LIFE INSURANCE COMPANY | 165 | $99K |
| Vision | VISION SERVICE PLAN | 148 | $26K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 205 | $69K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 205 | $74K |
| Other(6 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 205 | $145K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 205 | — |
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 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.