| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST | 55 E JACKSON BLVD STE 14A CHICAGO, IL 60604 | LINCOLN FINANCIAL GROUP | $28K | — | $28K | 5.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST | 203 N LASALLE ST FL 20 CHICAGO, IL 60601 | LINCOLN FINANCIAL GROUP | $22K | — | $22K | 3.94% |
| JAMES R NELLIGAN & ASSOCIATES LLC3 Filed as: JAMES R NELLIGAN & ASSOCIATES | 1933 STATE RTE 35 STE 368 WALL TOWNSHIP, NJ 07719 | LINCOLN FINANCIAL GROUP | — | $10K | $10K | 1.73% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST LTD | 3510 N CAUSEWAY BLVD METAIRIE, LA 70002 | RELISTAR LIFE INSURANCE COMPANY | $37K | — | $37K | 12.50% |
| ASSUREDPARTNERS3 Filed as: ASSUREDPARTNERS OF ARIZONA, LLC | 14614 N KIERLAND BLVD STE 150 SCOTTSDALE, AZ 85254 | RELISTAR LIFE INSURANCE COMPANY | $22K | — | $22K | 7.50% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SERV. | 600 CORPORATE POINTE FL 6 CULVER CITY, CA 90230 | RELISTAR LIFE INSURANCE COMPANY | $11K | — | $11K | 3.73% |
| PLANSOURCE BENEFITS ADMINISTRATION3 Filed as: PLANSOURCE BENEFITS ADMIN. INC. | 101 S GARLAND AVE STE 203 ORLANDO, FL 32801 | RELISTAR LIFE INSURANCE COMPANY | — | $4K | $4K | 1.33% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST | 55 E JACKSON BLVD STE 14A CHICAGO, IL 60604 | LINCOLN NATIONAL LIFE INSURANCE COMPANY | $13K | — | $13K | 5.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST | 203 N LASALLE ST FL 20 CHICAGO, IL 60601 | LINCOLN NATIONAL LIFE INSURANCE COMPANY | $10K | — | $10K | 3.83% |
| JAMES R NELLIGAN & ASSOCIATES LLC3 Filed as: JAMES R NELLIGAN & ASSOCIATES | 1933 STATE RTE 35 STE 368 WALL TOWNSHIP, NJ 07719 | LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $5K | $5K | 1.88% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST LTD. | PO BOX 2158 RIVERSIDE, CA 92516 | VISION SERVICE PLAN | $4K | — | $4K | 2.05% |
| ASSUREDPARTNERS3 Filed as: ASSUREDPARTNERS OF AZ LLC | 14614 N KIERLAND BLVD SUITE 15 SCOTTSDALE, AZ 85254 | VISION SERVICE PLAN | $2K | — | $2K | 0.97% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST | 55 E JACKSON BLVD STE 14A CHICAGO, IL 60604 | LINCOLN NATIONAL LIFE INSURANCE COMPANY | $6K | — | $6K | 4.73% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST | 203 N LASALLE ST FL 20 CHICAGO, IL 60601 | LINCOLN NATIONAL LIFE INSURANCE COMPANY | $5K | — | $5K | 3.53% |
| JAMES R NELLIGAN & ASSOCIATES LLC3 Filed as: JAMES R NELLIGAN & ASSOCIATES | 1933 STATE RTE 35 STE 368 WALL TOWNSHIP, NJ 07719 | LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $1K | $1K | 0.77% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTL MIDWEST LTD | 55 E JACKSON BLVD CHICAGO, IL 60604 | ALPHA DENTAL OF ARIZONA, INC. | $894 | — | $894 | 2.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| AETNA LIFE INSURANCE COMPANY EIN 06-6033492 CONTRACT ADMIN | Contract Administrator Service code 13 | — | $906K |
| BANNER HEALTH AND AETNA HEALTH INS. EIN 81-5281115 CONTRACT ADMIN | Contract Administrator Service code 13 | — | $155K |
| LINCOLN NATIONAL LIFE INSURANCE CO. EIN 35-0472300 LEAVE ASO | Claims processing; Contract Administrator Service code 12 | — | $59K |
| DELTA DENTAL OF AZ EIN 86-0274899 BENEFIT ADMIN | Contract Administrator; Claims processing Service code 12 | — | $55K |
| INSPIRA FINANCIAL COBRA ADMIN | Contract Administrator; Claims processing Service code 12 | 2001 SPRING RD SUITE 700 OAK BROOK, IL 60523 | $45K |
| VSP EIN 06-1227840 VISION ADMIN | Contract Administrator; Claims processing Service code 12 | — | $39K |
| RXBENEFITS EIN 63-1157085 RX ADMIN | Claims processing; Contract Administrator Service code 12 | — | $17K |
| HUB INTERNATIONAL MIDWEST AGENT | Insurance agents and brokers Service code 22 | 55 E JACKSON BLVD CHICAGO, IL 60604 | $6K |
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 | 1,804 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 13 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 92 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,909 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts) | KAISER FOUNDATION HEALTH PLAN, INC. | 207 | $2.4M |
| Dental | ALPHA DENTAL OF ARIZONA, INC. | 114 | $45K |
| Vision | VISION SERVICE PLAN | 1,049 | $218K |
| Life insurance | LINCOLN FINANCIAL GROUP | 1,804 | $564K |
| Short-term disability | LINCOLN NATIONAL LIFE INSURANCE COMPANY | 174 | $137K |
| Long-term disability | LINCOLN NATIONAL LIFE INSURANCE COMPANY | 775 | $267K |
| Other | RELISTAR LIFE INSURANCE COMPANY | 444 | $295K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,804 | — |
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.