Form 5500 · Employee benefit plan · CHICAGO, IL
PENINSULA HOTEL CHICAGO, LLC
The filing calls this plan THE PENINSULA GROUP HEALTH AND WELFARE BENEFIT PLAN.
PENINSULA HOTEL CHICAGO, LLC of CHICAGO, IL insures health, vision, life, disability and stop-loss coverage for its employees, per Schedule A of its Form 5500. Its broker of record is SCOTT HASKINS -SUPERIOR BENEFIT ADV. Coverage is written through HCC LIFE INSURANCE COMPANY and 3 other carriers. The plan's most recent policy period ended in December.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 36-4273832 · plan 501 · plan year 2025, filed Jul 10, 2026
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2,668 other employer plans in Illinois have policy years ending in December. See the full list on the renewal calendar, or ask for it in Claude or ChatGPT.
How this plan is funded
Self-funded as reported
The filing reports a stop-loss contract and no medical premium, which is what a plan that pays its own claims reports.
A stop-loss policy appears on a Form 5500 only when the plan itself is the beneficiary, or the premiums are paid from plan money. Many employers buy stop-loss and never report it here. So a plan with no stop-loss on its filing may still have it.
Benefits declared on this filing
3 contracts on this filing do not say which benefits they cover, so a line above may be insured by one of them.
Also declared: death benefits.
Declared benefits are the plan’s own line 8b codes on Form 5500. “Not on Schedule A” means no insured contract for that line appears on this filing. That usually means the benefit is self-funded, or it sits under a different plan number.
Persons covered is the count the carrier filed for that policy at the end of its policy year, and it can include dependents. Participants is the plan's own count at the start of its plan year. The two count different people, so a covered figure can be larger.
Plan brief
Schedule A lists 8 insured contracts covering health, vision, life, disability and stop-loss; the largest, with HCC LIFE INSURANCE COMPANY, covers 489 people.
The filing declares health, vision, disability and dental. Dental appears with no insured contract on Schedule A. That coverage may be self-funded, placed with a carrier that is not on this filing, or written on one of the 3 contracts here that do not say what they cover.
The medical plan carries stop-loss coverage: the filing reports the plan paying its own health claims, with insured protection against large ones.
Reported premium across the insured contracts is $1,728,224, with $220,940 in disclosed broker commissions — about 13% of premium.
The health contract's policy period ended in December, while at least one ancillary line's policy period ended in November. The plan is on a split renewal cycle.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| AETNA LIFE INSURANCE COMPANY | Health | 489 | Jan 1, 2026 | $379,057 | $124,024 |
| SUN LIFE ASSURANCE COMPANY OF CANADA | Life, Disability | 489 | Dec 1, 2025 | $454,996 | $44,615 |
| HCC LIFE INSURANCE COMPANY | Stop-loss | 489 | Jan 1, 2026 | $752,067 | $37,603 |
| SUN LIFE ASSURANCE COMPANY OF CANADA | Vision | 489 | Dec 1, 2025 | $41,901 | $6,276 |
| SUN LIFE ASSURANCE COMPANY OF CANADA | Stop-loss | 489 | Dec 1, 2025 | $25,139 | $4,391 |
| SUN LIFE ASSURANCE COMPANY OF CANADA | — | 489 | Dec 1, 2025 | $37,023 | $2,536 |
| SUN LIFE ASSURANCE COMPANY OF CANADA | — | 74 | Dec 1, 2025 | $34,367 | $944 |
| HARTFORD FIRE INSURANCE COMPANY | — | 489 | Nov 1, 2025 | $3,674 | $551 |
Covered = persons covered at policy year end, as filed on Schedule A for that policy — often certificates or one class, not the whole plan. Premium = the filing’s own premium/charges figure; “—” means not credibly reported.
Other plans filed by this employer
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