| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE | SERVICES INC. 4371 LATHAM ST., SUITE 101 RIVERSIDE, CA 92501 | BLUECROSS BLUESHIELD OF CALIFORNIA | $79K | — | $79K | 2.56% |
| ASSURANCE AGENCY LTD3 Filed as: ASSURANCE INSURANCE AGENCY | 20 N. MARTINGALE RD., STE. 100 SCHAUMBURG, IL 60173 | BLUECROSS BLUESHIELD OF CALIFORNIA | $75K | $95 | $75K | 2.44% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | ATTN. EMP BENEFITS DEPT. 55 E. JACKSON BLVD. #14A CHICAGO, IL 60604 | RELIASTAR LIFE INSURANCE COMPANY | $172K | — | $172K | 6.35% |
| ASSURANCE AGENCY LTD3 Filed as: ASSURANCE AGENCY LTD. | 20 N. MARTINGALE RD., STE. 100 SCHAUMBURG, IL 60173 | RELIASTAR LIFE INSURANCE COMPANY | $103K | — | $103K | 3.80% |
| EMPYREAN INSURANCE SERVICES, INC.3 | 9009 WEST LOOP S. STE. 600 HOUSTON, TX 77096 | RELIASTAR LIFE INSURANCE COMPANY | — | $80K | $80K | 2.98% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 55 E. JACKSON BLVD., FLOOR 14 CHICAGO, IL 60604 | METROPOLITAN LIFE INSURANCE COMPANY | $85K | $54 | $85K | 3.91% |
| EMPYREAN INSURANCE SERVICES, INC.3 Filed as: EMPYREAN INSURANCE SERVICES INC. | 3010 BRIARPARK DR., STE. 8000 HOUSTON, TX 77042 | METROPOLITAN LIFE INSURANCE COMPANY | — | $65K | $65K | 2.98% |
| ASSURANCE AGENCY LTD3 Filed as: ASSURANCE AGENCY LTD. | 20 N. MARTINGALE RD., STE. 100 SCHAUMBURG, IL 60173 | METROPOLITAN LIFE INSURANCE COMPANY | $44K | $6K | $50K | 2.29% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 16253 COLLECTION CENTER DR. CHICAGO, IL 60693 | METROPOLITAN LIFE INSURANCE COMPANY | — | $20K | $20K | 0.93% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 55 E. JACKSON BLVD. CHICAGO, IL 60604 | KAISER FOUNDATION HEALTH PLAN INC. | $19K | — | $19K | 3.27% |
| ASSURANCE AGENCY LTD3 Filed as: ASSURANCE AGENCY LTD. | 20 N. MARTINGALE RD., STE. 100 SCHAUMBURG, IL 60173 | KAISER FOUNDATION HEALTH PLAN INC. | $13K | — | $13K | 2.36% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 55 E. JACKSON BLVD. CHICAGO, IL 60604 | KAISER FOUNDATION HEALTH PLAN INC. | $19K | — | $19K | 3.60% |
| ASSURANCE AGENCY LTD3 Filed as: ASSURANCE AGENCY LTD. | 20 N. MARTINGALE RD., STE. 100 SCHAUMBURG, IL 60173 | KAISER FOUNDATION HEALTH PLAN INC. | $14K | — | $14K | 2.59% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 55 EAST JACKSON BLVD. CHICAGO, IL 60604 | KAISER FOUNDATION HEALTH PLAN OF HAWAII | $8K | — | $8K | 2.65% |
| ASSURANCE AGENCY LTD3 Filed as: ASSURANCE AGENCY LTD. | 20 N. MARTINGALE RD., STE. 100 SCHAUMBURG, IL 60173 | KAISER FOUNDATION HEALTH PLAN OF HAWAII | $3K | — | $3K | 0.78% |
| ASSURANCE AGENCY LTD3 Filed as: ASSURANCE AGENCY LTD. | 20 N. MARTINGALE RD., STE. 100 SCHAUMBURG, IL 60173 | SAFEGUARD HEALTH PLANS, INC., A CALIFORNIA CORPORATION | $610 | $92 | $702 | 2.26% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 55 E. JACKSON BLVD., FLOOR 14 CHICAGO, IL 60604 | SAFEGUARD HEALTH PLANS, INC., A CALIFORNIA CORPORATION | $698 | — | $698 | 2.25% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 16253 COLLECTION CENTER DR. CHICAGO, IL 60693 | SAFEGUARD HEALTH PLANS, INC., A CALIFORNIA CORPORATION | — | $174 | $174 | 0.56% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 55 E. JACKSON BLVD. CHICAGO, IL 60604 | EYEMED VISION CARE | $1K | — | $1K | 10.00% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH & MCLENNAN AGENCY | 4400 PGA BLVD. #1000 PALM BEACH GARDENS, FL 33410 | EYEMED VISION CARE | $916 | — | $916 | 9.83% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 55 E. JACKSON BLVD., 14TH FLOOR CHICAGO, IL 60604 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $800 | — | $800 | 15.00% |
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 | 4,776 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 38 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 4,814 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(5 contracts, 4 carriers) | BLUECROSS BLUESHIELD OF CALIFORNIA | 616 | $4.5M |
| Dental(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 5,806 | $2.2M |
| Vision(5 contracts) | EYEMED VISION CARE | 4,972 | $317K |
| Life insurance | RELIASTAR LIFE INSURANCE COMPANY | 4,776 | $2.7M |
| Short-term disability | RELIASTAR LIFE INSURANCE COMPANY | 4,776 | $2.7M |
| Long-term disability | RELIASTAR LIFE INSURANCE COMPANY | 4,776 | $2.7M |
| Prescription drug | BLUECROSS BLUESHIELD OF CALIFORNIA | 616 | $3.1M |
| Other | RELIASTAR LIFE INSURANCE COMPANY | 4,776 | $2.7M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 5,806 | — |
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.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.