| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 | 55 E JACKSON BLVD CHICAGO, IL 606044466 | KAISER FOUNDATION HEALTH PLAN | $55K | — | $55K | 4.55% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | PO BOX 2158 RIVERSIDE, CA 92506 | UNITEDHEALTHCARE INSURANCE COMPANY | $21K | — | $21K | 3.55% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNTIONAL MIDWEST LIMITED | 55 E JACKSON BLVD CHICAGO, IL 606044466 | KAISER FOUNDATION HEALTH PLAN, INC. | $11K | — | $11K | 4.62% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UMR, INC. EIN 39-1995276 CLAIMS PROCESSING | Claims processing Service code 12 | — | $518K |
| UNITED BEHAVIORAL HEALTH DBA OPTUM EIN 94-2649097 CONTRACT ADMINISTRATORS | Contract Administrator Service code 13 | — | $42K |
| RXBENEFITS 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 | 2,370 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 15 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 2,385 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN, INC. | 25 | $239K |
| Dental | UNITEDHEALTHCARE INSURANCE COMPANY | 1,565 | $592K |
| Vision | UNITEDHEALTHCARE INSURANCE COMPANY | 1,238 | $112K |
| Life insurance | UNITEDHEALTHCARE INSURANCE COMPANY | 2,435 | $606K |
| Short-term disability | UNITEDHEALTHCARE INSURANCE COMPANY | 2,435 | $606K |
| Long-term disability | UNITEDHEALTHCARE INSURANCE COMPANY | 2,435 | $606K |
| Stop-loss / reinsurancereinsurance | UNITEDHEALTHCARE STOP LOSS UNITED HEALTH | 1,217 | $987K |
| Other | UNITEDHEALTHCARE INSURANCE COMPANY | 2,435 | $606K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,435 | — |
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.