| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 | 125 S WACKER DR STE 300 CHICAGO, IL 60606 | STANDARD INSURANCE COMPANY | $50K | — | $50K | 4.92% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 125 S WACKER DR STE 300 CHICAGO, IL 60606 | STANDARD INSURANCE COMPANY | $12K | — | $12K | 2.30% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST LTD | 3390 UNIVERSITY AVE, SUITE 300 RIVERSIDE, CA 92501 | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $25K | — | $25K | 6.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 125 S WACKER DR STE 300 CHICAGO, IL 60606 | STANDARD INSURANCE COMPANY | $10K | — | $10K | 4.90% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | ATTN. EMP BENEFITS DEPT 55 EAST JACKSON BLVD #14A CHICAGO, IL 60604 | RELIASTAR LIFE INSURANCE COMPANY | $57K | — | $57K | 27.45% |
| WEX HEALTH, INC.3 | 82 HOPMEADOW ST STE 220 WEATOGUE, CT 060899694 | RELIASTAR LIFE INSURANCE COMPANY | — | $7K | $7K | 3.47% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST LTD | 16253 COLLECTION CENTER DR 40 W MADISON 4TH FL BANK OF AMERICA CHICAGO, IL 606930162 | METROPOLITAN LIFE INSURANCE COMPANY | — | $975 | $975 | 0.88% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 55 E JACKSON BLVD CHICAGO, IL 606044466 | METROPOLITAN LIFE INSURANCE COMPANY | — | $47 | $47 | 0.04% |
| EOI SERVICE COMPANY INC3 Filed as: EOI SERVICE COMPANY | 212 W KINZIE ST 4TH FLOOR CHICAGO, IL 60654 | COMBINED INSURANCE | $21K | — | $21K | 31.26% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 55 E JACKSON BLVD CHICAGO, IL 60604 | COMBINED INSURANCE | $7K | — | $7K | 10.50% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | EMPLOYEE BENEFITS DEPT. 55 E JACKSON BLVD #14A CHICAGO, IL 60604 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $794 | — | $794 | 17.31% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST LTD | EMPLOYEE BENEFITS DEPT 55 E JACKSON BLVD #14A CHICAGO, IL 60604 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | — | $113 | $113 | 2.46% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| LYRA CLINICAL ASSOCIATES P.C. EIN 47-5645538 CONTRACT ADMINISTRATOR | Direct payment from the plan; Other services Service code 49 | — | $203K |
| TELUS HEALTH (US) LTD EIN 52-1883918 CONTRACT ADMINISTRATOR | Claims processing; Contract Administrator Service code 12 | — | $37K |
| RXBENEFITS, INC. EIN 63-1157085 CLAIMS PROCESSING | Claims processing; Contract Administrator Service code 12 | — | $10K |
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 | 7,883 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 110 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 7,993 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HAWAII MEDICAL SERVICE ASSOCIATION | 68 | $95K |
| Dental(2 contracts, 2 carriers) | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 4,145 | $518K |
| Vision(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 5,315 | $206K |
| Life insurance | STANDARD INSURANCE COMPANY | 7,712 | $502K |
| Short-term disability | STANDARD INSURANCE COMPANY | 6,904 | $1.0M |
| Long-term disability | STANDARD INSURANCE COMPANY | 5,436 | $211K |
| Stop-loss / reinsurancereinsurance | SWISS RE-SWISS RE | 4,711 | $926K |
| Other(3 contracts, 3 carriers) | RELIASTAR LIFE INSURANCE COMPANY | 2,330 | $279K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 7,712 | — |
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.