| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 | 55 E JACKSON BLVD CHICAGO, IL 606044466 | KAISER FOUNDATION HEALTH PLAN | $64K | — | $64K | 4.96% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | PO BOX 2158 RIVERSIDE, CA 92506 | UNITEDHEALTHCARE INSURANCE COMPANY | $52K | — | $52K | 5.88% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNTIONAL MIDWEST LIMITED | 55 E JACKSON BLVD CHICAGO, IL 606044466 | KAISER FOUNDATION HEALTH PLAN, INC. | $9K | — | $9K | 4.95% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UMR, INC. EIN 39-1995276 CLAIMS PROCESSING | Claims processing Service code 12 | — | $810K |
| FLORES AND ASSOCIATES EIN 56-1542307 CONTRACT ADMINISTRATORS | Contract Administrator Service code 13 | — | $19K |
| RXBENEFITS EIN 63-1157085 CLAIMS PROCESSING | Claims processing; Contract Administrator Service code 12 | — | $11K |
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 | 2,344 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 21 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 2,365 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN, INC. | 22 | $178K |
| Dental | UNITEDHEALTHCARE INSURANCE COMPANY | 1,494 | $635K |
| Vision | UNITEDHEALTHCARE INSURANCE COMPANY | 1,207 | $112K |
| Life insurance | UNITEDHEALTHCARE INSURANCE COMPANY | 2,240 | $887K |
| Short-term disability | UNITEDHEALTHCARE INSURANCE COMPANY | 2,240 | $887K |
| Long-term disability | UNITEDHEALTHCARE INSURANCE COMPANY | 2,240 | $887K |
| Stop-loss / reinsurancereinsurance | UNITEDHEALTHCARE STOP LOSS UNITED HEALTH | 1,158 | $968K |
| Other | UNITEDHEALTHCARE INSURANCE COMPANY | 2,240 | $887K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,240 | — |
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."
No prospect flags tripped on this filing.