| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 | 55 E JACKSON BLVD CHICAGO, IL 60604 | SUN LIFE ASSURANCE COMPANY OF CANADA | $33K | — | $33K | 4.57% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SERVICE | 3390 UNIVERSITY AVE #300 RIVERSIDE, CA 92501 | SUN LIFE ASSURANCE COMPANY OF CANADA | — | $22K | $22K | 3.01% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 55 E JACKSON BLVD CHICAGO, IL 60604 | METROPOLITAN LIFE INSURANCE COMPANY | $14K | — | $14K | 4.60% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 16253 COLLECTION CENTER DR CHICAGO, IL 60693 | METROPOLITAN LIFE INSURANCE COMPANY | — | $5K | $5K | 1.66% |
| FST ASSOCIATION INC3 | 55 W MONROE ST STE 500 CHICAGO, IL 60603 | METROPOLITAN LIFE INSURANCE COMPANY | $4K | $687 | $5K | 1.54% |
| CUSTOM BENEFIT PROGRAMS INC3 Filed as: CUSTOM BENEFIT PROGRAMS | 897 12TH STREET HAMMONTON, NJ 08037 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $12K | $3K | $15K | 9.73% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST | 15162 COLLECTIONS CTR DR CHICAGO, IL 60693 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $3K | — | $3K | 1.77% |
| ENROLLMENT RESOURCES GROUP3 | 233 S WACKER DR STE 1875 CHICAGO, IL 60603 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $347 | — | $347 | 0.23% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF MINNESOTA INC | PO BOX 93076 CHICAGO, IL 60673 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $258 | — | $258 | 0.17% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST LTD | 55 E JACKSON BLVD #14A CHICAGO, IL 60604 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | — | $102 | $102 | 0.07% |
| EBC, INC.3 Filed as: EBC INC | PO BOX 20443 INDIANAPOLIS, IN 46220 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $25 | — | $25 | 0.02% |
| MARY S PYLE3 | PO BOX 2608 GULFPORT, MS 39505 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $23 | — | $23 | 0.02% |
| MATTHEW J ORDILLE3 | 77 PINTAIL DRIVE GLASSBORO, NJ 08028 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $16 | — | $16 | 0.01% |
| PEDEN, ROBERT, P3 | 18 53RD ST GULFPORT, MS 39507 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $11 | — | $11 | 0.01% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 15162 COLLECTION CENTER DR CHICAGO, IL 60693 | VISION SERVICE PLAN | $6K | — | $6K | 6.98% |
| CUSTOM BENEFIT PROGRAMS INC3 | 897 12TH ST HAMMONTON, NJ 08037 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $7K | $360 | $8K | 11.03% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST | 15162 COLLECTIONS CTR DR CHICAGO, IL 60693 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $3 | $2K | 2.80% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UNITED HEALTHCARE SERVICES, INC EIN 41-1289245 CLAIMS PROCESSOR | Other services; Claims processing Service code 12 | — | $688K |
| METROPOLITAN LIFE INSURANCE CO. EIN 13-5581829 CLAIMS PROCESSOR | Contract Administrator; Claims processing Service code 12 | — | $30K |
| HUB INTERNATIONAL MIDWEST LIMITED EIN 35-0672425 BROKER | Other commissions Service code 55 | — | $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 | 777 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 8 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 785 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | VISION SERVICE PLAN | 738 | $87K |
| Life insurance(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 1,164 | $458K |
| Short-term disability | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 604 | $153K |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 1,164 | $305K |
| Stop-loss / reinsurancereinsurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 805 | $722K |
| Other(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 1,164 | $376K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,164 | — |
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.
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.