| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| STHEALTH BENEFIT SOLUTIONS LLC3 | 18940 N PIMA ROAD SUITE 210 SCOTTSDALE, AZ 85255 | SUN LIFE ASSURANCE COMPANY OF CANADA | $31K | — | $31K | 4.59% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SERVICE | 3390 UNIVERSITY AVE #300 RIVERSIDE, CA 92501 | SUN LIFE ASSURANCE COMPANY OF CANADA | — | $19K | $19K | 2.74% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 16253 COLLECTIONS CENTER DR CHICAGO, IL 60693 | SUN LIFE ASSURANCE COMPANY OF CANADA | — | $10K | $10K | 1.46% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 55 E. JACKSON BLVD, 14TH FLOOR A CHICAGO, IL 60604 | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | $27K | — | $27K | 4.18% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 15162 COLLECTION CENTER DR CHICAGO, IL 60693 | VISION SERVICE PLAN | $7K | — | $7K | 3.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 55 E JACKSON BLVD, 14TH FLOOR A CHICAGO, IL 60604 | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | $9K | — | $9K | 4.21% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 55 E JACKSON BLVD, 14TH FLOOR A CHICAGO, IL 60604 | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | $8K | — | $8K | 4.15% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | EMPLOYEE BENEFITS DEPARTMENT 55 E JACKSON BLVD #14A CHICAGO, IL 60604 | AETNA LIFE INSURANCE COMPANY AND AFFILIATES | $1K | — | $1K | 2.20% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE CO. EIN 59-1031071 CLAIM ADMINISTRATOR | Participant communication; Named fiduciary; Float revenue; Claims processing; Contract Administrator; Direct payment from the plan; Other services; Non-monetary compensation Service code 12 | — | $1.0M |
| HUB INTERNATIONAL MIDWEST LTD BROKER | Insurance agents and brokers Service code 22 | 55 E JACKSON BLVD CHICAGO, IL 60604 | $66K |
| AETNA LIFE INSURANCE COMPANY EIN 06-6033492 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | 151 FARMINGTON AVENUE HARTFORD, CT 06156 | $58K |
| LIBERTY MUTUAL LEAVE SERVICES EIN 04-6076039 CONTRACT ADMINISTRATOR | Claims processing; Contract Administrator; Insurance services Service code 12 | — | $34K |
| CIGNA BEHAVIORAL HEALTH, INC. EIN 41-1648670 CONTRACT ADMINISTRATOR | Claims processing; Contract Administrator; Direct payment from the plan; Participant communication Service code 12 | — | $33K |
| RX BENEFITS INC. EIN 63-1157085 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | — | $18K |
| LIBERTY LIFE ASSURANCE CO OF BOSTON EIN 04-6076039 CONTRACT ADMINISTRATOR | Contract Administrator; Claims processing; Insurance services Service code 12 | — | $13K |
| CIGNA | Non-monetary compensation; Contract Administrator; Foreign entity (e.g., an agent or broker, bank, insurance company, etc. not operating within jurisdictional boundaries of the United States); Other services; Claims processing; Named fiduciary; Float revenue; Participant communication; Direct payment from the plan Service code 12 | — | $0 |
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 | 1,763 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 9 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,772 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 940 | $9K |
| Dental | AETNA LIFE INSURANCE COMPANY AND AFFILIATES | 245 | $61K |
| Vision | VISION SERVICE PLAN | 1,192 | $220K |
| Life insurance | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | 1,693 | $636K |
| Short-term disability | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | 443 | $215K |
| Long-term disability | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | 871 | $199K |
| Stop-loss / reinsurancereinsurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 1,084 | $684K |
| Other | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | 1,693 | $636K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,693 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.