| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ENROLLEASE3 Filed as: STRATEGIC BENEFIT RESOURCES | 2839 PACES FERRY RD SE SUITE 830 ATLANTA, GA 30339 | GRANULAR INSURANCE COMPANY | $102K | — | $102K | 7.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST LTD | EMPLOYEE BENEFITS DEPT 55 E JACKSON BLVD #14A CHICAGO, IL 60604 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $17K | $17K | 2.68% |
| JAMES R NELLIGAN & ASSOCIATES LLC3 | 1933 STATE RTE 35 STE 368 WALL, NJ 07719 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $12K | $12K | 1.92% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 Filed as: EDGEWOOD PARTNERS INSURANCE CETNER | P.O. BOX 5668 CONCORD, CA 94520 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $260 | $260 | 0.04% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDDWEST LTD | EMPLOYEE BENEFITS DEPT 55 E JACKSON BLVD #14A CHICAGO, IL 60604 | FIRST UNUM LIFE INSURANCE COMPANY | $13K | $4K | $17K | 13.12% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | PO BOX 5668 CONCORD, CA 94520 | FIRST UNUM LIFE INSURANCE COMPANY | $59 | $12 | $71 | 0.06% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST LTD | EMPLOYEE BENEFITS DEPT 55 E JACKSON BLVD #14A CHICAGO, IL 60604 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $5K | $5K | 3.87% |
| JAMES R NELLIGAN & ASSOCIATES LLC3 | 1933 STATE RTE 35 STE 368 WALL, NJ 07719 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $2K | $2K | 1.85% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | P.O. BOX 5668 CONCORD, CA 94520 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $73 | $73 | 0.06% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST LTD | EMPLOYEE BENEFITS DEPTS 55 E JACKSON BLVD #14A CHICAGO, IL 60604 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $459 | $459 | 3.25% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | PO BOX 5668 CONCORD, CA 94520 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $12 | $2 | $14 | 11.86% |
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 | 1,381 | 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. |
| Total participants (= "Plan participants" tile) | 1,381 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts) | KAISER FOUNDATION HEALTH PLAN INC. | 68 | $758K |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 2,766 | $1.9M |
| Vision | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 2,766 | $1.9M |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,381 | $622K |
| Short-term disability(3 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,381 | $636K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,381 | $622K |
| Prescription drug(2 contracts) | KAISER FOUNDATION HEALTH PLAN INC. | 68 | $758K |
| Stop-loss / reinsurancereinsurance | GRANULAR INSURANCE COMPANY | 1,391 | $1.5M |
| Other(4 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,534 | $894K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,766 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.