| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 | 55 E JACKSON BLVD CHICAGO, IL 60604 | SUN LIFE ASSURANCE COMPANY OF CANADA | — | $43K | $43K | 5.93% |
| STEALTH PARTNER GROUP LLC3 | 18940 N PIMA RD SUITE 210 SCOTTSDALE, AZ 85255 | SUN LIFE ASSURANCE COMPANY OF CANADA | $37K | — | $37K | 5.05% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST | 55 E JACKSON 12TH FL CHICAGO, IL 60604 | LINCOLN LIFE ASSURANCE COMPANY OF BOSTON | $29K | $12K | $40K | 6.06% |
| CENTRO BENEFITS RESEARCH LLC3 Filed as: CENTRO BENEFITS RESEARCH | 325 N KIRKWOOD RD STE 300 KIRKWOOD, MO 63122 | LINCOLN LIFE ASSURANCE COMPANY OF BOSTON | — | $11K | $11K | 1.59% |
| JAMES R NELLIGAN & ASSOCS LLC3 Filed as: JAMES R NELLIGAN & ASSOCS | 2338 IMMOKALEE RD STE 240 NAPLES, FL 34110 | LINCOLN LIFE ASSURANCE COMPANY OF BOSTON | — | $4K | $4K | 0.63% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST | 55 E JACKSON BLVD, STE 14A CHICAGO, IL 60604 | LINCOLN NATIONAL LIFE INSURANCE COMPANY | $11K | — | $11K | 4.28% |
| CENTRO BENEFITS RESEARCH LLC3 Filed as: CENTRO BENEFITS RESEARCH | 325 N KIRKWOOD RD STE 300 KIRKWOOD, MO 63122 | LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $6K | $6K | 2.49% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST | 55 E JACKSON 12TH FL CHICAGO, IL 60604 | LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $5K | $5K | 1.80% |
| JAMES R NELLIGAN & ASSOCS LLC3 Filed as: JAMES R NELLIGAN & ASSOCS | 2338 IMMOKALEE RD STE 240 NAPLES, FL 34110 | LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $2K | $2K | 0.62% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 15162 COLLECTION CENTER DR FL 14 CHICAGO, IL 60693 | VISION SERVICE PLAN | $6K | — | $6K | 3.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 55 E JACKSON BLVD, 14TH FLOOR A CHICAGO, IL 60604 | LINCOLN NATIONAL LIFE INSURANCE COMPANY | $8K | $4K | $11K | 6.32% |
| CENTRO BENEFITS RESEARCH LLC3 Filed as: CENTRO BENEFITS RESEARCH | 325 N KIRKWOOD RD STE 300 KIRKWOOD, MO 63122 | LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $4K | $4K | 2.52% |
| JAMES R NELLIGAN & ASSOCS LLC3 Filed as: JAMES R NELLIGAN & ASSOCS | 2338 IMMOKALEE RD STE 240 NAPLES, FL 34110 | LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $1K | $1K | 0.62% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST LTD | 55 E JACKSON BLVD CHICAGO, IL 60604 | ALPHA DENTAL OF ARIZONA, INC. | $933 | — | $933 | 1.83% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| AETNA LIFE INSURANCE COMPANY EIN 06-6033492 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | 151 FARMINGTON AVE. HARTFORD, CT 06156 | $840K |
| BANNER HEALTH AND AETNA HEALTH INS EIN 81-5281115 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | 4500 EAST COTTON CENTER BLVD PHOENIX, AZ 85040 | $101K |
| DELTA DENTAL OF ARIZONA EIN 86-0274899 CLAIMS PROCESSING | Contract Administrator; Claims processing Service code 12 | — | $45K |
| LIBERTY NATIONAL LIFE INSURANCE CO EIN 35-0472300 CONTRACT ADMINISTRATOR | Claims processing; Contract Administrator; Insurance services Service code 12 | — | $37K |
| RX BENEFITS INC. EIN 63-1157085 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | — | $16K |
| LINCOLN NATIONAL LIFE INSURANCE CO EIN 35-0472300 BROKER | Insurance agents and brokers Service code 22 | — | $15K |
| HUB INTERNATIONAL MIDWEST LIMITED BROKER | Insurance agents and brokers Service code 22 | 55 E JACKSON BOULEVARD 14TH FLOOR A CHICAGO, IL 60604 | $2K |
| HUB INTERNATIONAL MIDWEST BROKER | Insurance agents and brokers Service code 22 | 55 E JACKSON BLVD, STE 14A CHICAGO, IL 60604 | $622 |
| CENTRO BENEFITS RESEARCH BROKER | Other commissions Service code 55 | 325 N KIRKWOOD RD STE 300 KIRKWOOD, MO 63122 | $0 |
| JAMES R NELLIGAN & ASSOCS BROKER | Other commissions; Insurance agents and brokers Service code 22 | 2338 IMMOKALEE RD STE 240 NAPLES, FL 34110 | $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 | 972 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 6 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 978 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | ALPHA DENTAL OF ARIZONA, INC. | 249 | $51K |
| Vision | VISION SERVICE PLAN | 1,047 | $208K |
| Life insurance | LINCOLN LIFE ASSURANCE COMPANY OF BOSTON | 1,602 | $666K |
| Short-term disability | LINCOLN NATIONAL LIFE INSURANCE COMPANY | 265 | $177K |
| Long-term disability | LINCOLN NATIONAL LIFE INSURANCE COMPANY | 730 | $253K |
| Stop-loss / reinsurancereinsurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 1,163 | $729K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,602 | — |
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.