| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| STHEALTH BENEFIT SOLUTIONS LLC3 Filed as: STHEALTH BENEFIT SOLUTIONS LLC DBA | STEALTH PARTNER GROUP 18940 N PIMA RD SUITE 210 SCOTTSDALE, AZ 85255 | SUN LIFE ASSURANCE COMPANY OF CANADA | $41K | — | $41K | 5.01% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 55 E JACKSON BLVD CHICAGO, IL 60604 | SUN LIFE ASSURANCE COMPANY OF CANADA | — | $37K | $37K | 4.58% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 55 E. JACKSON BLVD, 14TH FLOOR A CHICAGO, IL 60604 | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | $38K | $8K | $46K | 6.04% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 55 E JACKSON BLVD, 14TH FLOOR A CHICAGO, IL 60604 | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | $14K | $3K | $17K | 6.03% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 55 E JACKSON BLVD, 14TH FLOOR A CHICAGO, IL 60604 | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | $12K | $3K | $15K | 6.39% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 15162 COLLECTION CENTER DR CHICAGO, IL 60693 | VISION SERVICE PLAN | $6K | — | $6K | 2.86% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 55 E JACKSON BLVD CHICAGO, IL 60604 | ALPHA DENTAL OF ARIZONA, INC. | $1K | — | $1K | 2.00% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS LLC | 208 S LASALLE ST SUITE 514 CHICAGO, IL 60604 | ALPHA DENTAL OF ARIZONA, INC. | $1 | — | $1 | 0.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| AETNA LIFE INSURANCE COMPANY EIN 06-6033492 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | — | $1.1M |
| BANNER HEALTH AND AETNA HEALTH INS EIN 81-5281115 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | 4500 EAST COTTON CENTER BLVD PHOENIX, AZ 85040 | $252K |
| LIBERTY LIFE ASSURANCE CO OF BOSTON EIN 04-6076039 CONTRACT ADMINISTRATOR | Contract Administrator; Insurance services; Claims processing Service code 12 | — | $66K |
| DELTA DENTAL OF ARIZONA EIN 86-0274899 CLAIMS PROCESSING | Claims processing; Contract Administrator Service code 12 | — | $55K |
| RX BENEFITS INC. EIN 63-1157085 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | — | $18K |
| HUB INTERNATIONAL MIDWEST LTD BROKER | Insurance agents and brokers Service code 22 | 55 E JACKSON BLVD CHICAGO, IL 60604 | $10K |
| HUB INTERNATIONAL MIDWEST LIMITED BROKER | Insurance agents and brokers Service code 22 | 55 E JACKSON BOULEVARD 14TH FLOOR A CHICAGO, IL 60604 | $3K |
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 | 2,259 | 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) | 2,259 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | ALPHA DENTAL OF ARIZONA, INC. | 336 | $64K |
| Vision | VISION SERVICE PLAN | 1,372 | $227K |
| Life insurance | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | 1,888 | $767K |
| Short-term disability | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | 347 | $235K |
| Long-term disability | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | 843 | $274K |
| Stop-loss / reinsurancereinsurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 1,224 | $817K |
| Other | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | 1,888 | $767K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,888 | — |
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.