| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 | 56 EAST JACKSON BLVD #14A CHICAGO, IL 60604 | AETNA LIFE INSURANCE CO. | $49K | — | $49K | 2.67% |
| SWBC LIFE INSURANCE AGENCY, INC.3 Filed as: SWBC LIFE INSURANCE AGENCY INC | 9311 SAN PEDRO AVE SUITE 600 SAN ANTONIO, TX 78216 | AETNA LIFE INSURANCE CO. | $11K | — | $11K | 0.58% |
| FOREST FINANCIAL GROUP INC3 | 580 N BANK LN STE 101 LAKE FOREST, IL 600455303 | METROPOLITAN LIFE INSURANCE COMPANY | $8K | $7K | $14K | 5.08% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 15162 COLLECTION CENTER DR CHICAGO, IL 606930151 | METROPOLITAN LIFE INSURANCE COMPANY | $12K | — | $12K | 4.16% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 16253 COLLECTION CENTER DR 40 W MADISON 4TH FL BANK OF CHICAGO, IL 606930162 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $3K | $3K | 1.00% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INS SERVICES LLC | 1 INTERNATIONAL PLZ STE 400 PHILADELPHIA, PA 191131535 | METROPOLITAN LIFE INSURANCE COMPANY | $706 | $0 | $706 | 0.25% |
No Schedule C service providers reported on this filing.
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 | 607 | 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. |
| Beneficiaries receiving benefits | 0 | Spouses or dependents with eligibility independent of the participant. |
| Total participants (= "Plan participants" tile) | 607 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | AETNA LIFE INSURANCE CO. | 338 | $1.8M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 607 | $285K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 607 | $285K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 607 | $285K |
| Short-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 607 | $285K |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 607 | $285K |
| Other | METROPOLITAN LIFE INSURANCE COMPANY | 607 | $285K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 607 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.