| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 | 4830 WEST KENNEDY BLVD. STE. 850 TAMPA, FL 33609 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $14K | $160K | $174K | 4.15% |
| NFP INSURANCE SERVICES INC3 Filed as: NFP CORPORATE SERVICE (NY), LLC | PO BOX 786677 21ST FLOOR PHILADELPHIA, PA 19178 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $0 | -$311 | -$311 | -0.01% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | PO BOX 1027 CLEARWATER, FL 33757 | MUTUAL OF OMAHA | $4K | $4K | $8K | 17.85% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | PO BOX 1027 CLEARWATER, FL 33757 | MUTUAL OF OMAHA | $3K | $4K | $7K | 18.29% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | PO BOX 1027 CLEARWATER, FL 33757 | COMPANION LIFE INSURANCE COMPANY | $0 | $1K | $1K | 9.68% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 4830 WEST KENNEDY BLVD. STE. 850 TAMPA, FL 33609 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $672 | $0 | $672 | 5.68% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 4830 WEST KENNEDY BLVD. STE. 850 TAMPA, FL 33609 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $1K | $0 | $1K | 11.27% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | PO BOX 1027 CLEARWATER, FL 33757 | COMPANION LIFE INSURANCE COMPANY | $512 | $484 | $996 | 19.47% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | PO BOX 1027 CLEARWATER, FL 33757 | MUTUAL OF OMAHA | $229 | $256 | $485 | 21.22% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | PO BOX 1027 CLEARWATER, FL 33757 | MUTUAL OF OMAHA | $128 | $121 | $249 | 19.47% |
No Schedule C service providers reported on this filing.
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 | 210 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 3 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 213 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 275 | $4.2M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 275 | $4.2M |
| Vision | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 275 | $4.2M |
| Life insurance(3 contracts, 2 carriers) | COMPANION LIFE INSURANCE COMPANY | 212 | $19K |
| Short-term disability | MUTUAL OF OMAHA | 215 | $44K |
| Long-term disability | MUTUAL OF OMAHA | 212 | $39K |
| Other(5 contracts, 4 carriers) | COMPANION LIFE INSURANCE COMPANY | 212 | $37K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 275 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.