| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ARTEMIS RISK SOLUTIONS, LLC3 | 14841 DALLAS PARKWAY, N735 DALLAS, TX 75254 | BLUE CROSS OF CALIFORNIA | $70K | $0 | $70K | 4.97% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS., INC. | PO BOX 2158 RIVERSIDE, CA 92516 | BLUE CROSS OF CALIFORNIA | $0 | $303 | $303 | 0.02% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 2120 PEWAUKEE ROAD, SUITE 202 WAUKESHA, WI 53188 | BLUE CROSS OF CALIFORNIA | $39 | $0 | $39 | 0.00% |
| ARTEMIS RISK SOLUTIONS, LLC3 | 9651 CLAYTON ROAD, SUITE 2F SAINT LOUIS, MO 63124 | KAISER FOUNDATION HEALTH PLAN, INC. | $42K | $0 | $42K | 4.50% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 55 EAST JACKSON BOULEVARD CHICAGO, IL 60604 | KAISER FOUNDATION HEALTH PLAN, INC. | $56 | $0 | $56 | 0.01% |
| ARTEMIS RISK SOLUTIONS, LLC3 Filed as: ARTEMIS RISK SOLUTIONS | 9651 CLAYTON ROAD, SUITE 2F SAINT LOUIS, MO 63124 | METROPOLITAN LIFE INSURANCE COMPANY | $17K | $0 | $17K | 5.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 203 NORTH LA SALLE STREET 20TH FLOOR CHICAGO, IL 60601 | METROPOLITAN LIFE INSURANCE COMPANY | $2K | $261 | $2K | 0.57% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 16253 COLLECTION CENTER DRIVE 40 WEST MADISON, 4TH FLOOR CHICAGO, IL 60693 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $1K | $1K | 0.33% |
| BENEFIT EDUCATORS LLC3 Filed as: BENEFIT EDUCATORS, LLC | 1954 SUNSET RIDGE ROAD GLENVIEW, IL 60025 | METROPOLITAN LIFE INSURANCE COMPANY | $1K | $0 | $1K | 0.33% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 55 EAST JACKSON BOULEVARD 12A FLOOR CHICAGO, IL 60604 | KAISER FOUNDATION HEALTH PLAN OF COLORADO | $1K | $0 | $1K | 2.99% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST LTD. | 55 EAST JACKSON BOULEVARD CHICAGO, IL 60604 | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON | $159 | $0 | $159 | 2.39% |
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 | 322 | 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) | 322 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 4 carriers) | BLUE CROSS OF CALIFORNIA | 136 | $2.4M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 474 | $344K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 474 | $344K |
| Life insurance | STANDARD INSURANCE COMPANY | 339 | $0 |
| Short-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 474 | $344K |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 474 | $344K |
| Prescription drug(3 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 102 | $964K |
| Other(3 contracts, 3 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 474 | $348K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 474 | — |
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.