Form 5500 · Employee benefit plan · CHICAGO, IL
PENINSULA HOTEL CHICAGO, LLC
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 · as of Aug 2026
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 medical plan carries stop-loss coverage, which usually signals a self-funded health plan with insured protection against large claims.
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 renews in November — the plan is on a split renewal cycle.
SCOTT HASKINS -SUPERIOR BENEFIT ADV is the broker of record on 1 of the 8 contracts; the rest name a different broker or none.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| AETNA | Health | 489 | December | $379,057 | $124,024 |
| SUN LIFE ASSURANCE COMPANY OF CANADA | Life, Disability | 489 | November | $454,996 | $44,615 |
| HCC LIFE INSURANCE COMPANY | Stop-loss | 489 | December | $752,067 | $37,603 |
| SUN LIFE ASSURANCE COMPANY OF CANADA | Vision | 489 | November | $41,901 | $6,276 |
| SUN LIFE ASSURANCE COMPANY OF CANADA | Stop-loss | 489 | November | $25,139 | $4,391 |
| SUN LIFE ASSURANCE COMPANY OF CANADA | — | 489 | November | $37,023 | $2,536 |
| SUN LIFE ASSURANCE COMPANY OF CANADA | — | 74 | November | $34,367 | $944 |
| HARTFORD FIRE INSURANCE COMPANY | — | 489 | October | $3,674 | $551 |
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