| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARSH & MCLENNAN AGENCY LLC3 | UNKNOWN UNKNOWN, MN 00000 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $47K | $0 | $47K | 10.72% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL OF CA INS SVCS | PO BOX 2158 RIVERSIDE, CA 92516 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | -$5K | $0 | -$5K | -1.08% |
| MARSH & MCLENNAN AGENCY LLC3 | LOCKBOX 740659 LOS ANGELES, CA 90074 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $6K | $0 | $6K | 7.05% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS | PO BOX 2158 RIVERSIDE, CA 92516 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $49 | $0 | $49 | 0.05% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL OF CALI | 580 CALIFORNIA ST STE 1300 SAN FRANSISCO, CA 94104 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | $720 | $4K | 9.10% |
| MARSH & MCLENNAN AGENCY LLC3 | 2300 RENAISSANCE BLVD KING OF PRUSSIA, PA 19406 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | $0 | $2K | 6.23% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL OF CALI | 580 CALIFORNIA ST STE 1300 SAN FRANSISCO, CA 94104 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | $587 | $3K | 9.04% |
| MARSH & MCLENNAN AGENCY LLC3 | 2300 RENAISSANCE BLVD KING OF PRUSSIA, PA 19406 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | $0 | $2K | 7.09% |
| MARSH & MCLENNAN AGENCY LLC3 | 6160 GOLDEN HILLS DR MINNEAPOLIS, MN 55416 | KAISER FOUNDATION HEALTH PLAN INC | $1K | $0 | $1K | 4.11% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SERVICES, INC | PO BOX 2158 RIVERSIDE, CA 92516 | KAISER FOUNDATION HEALTH PLAN INC | $261 | $0 | $261 | 0.94% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL OF CALI | 580 CALIFORNIA ST STE 1300 SAN FRANSISCO, CA 94104 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | $257 | $2K | 11.44% |
| MARSH & MCLENNAN AGENCY LLC3 | 2300 RENAISSANCE BLVD KING OF PRUSSIA, PA 19406 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | $0 | $2K | 8.41% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL OF CALI | 580 CALIFORNIA ST STE 1300 SAN FRANSISCO, CA 94104 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $352 | $66 | $418 | 12.33% |
| MARSH & MCLENNAN AGENCY LLC3 | 2300 RENAISSANCE BLVD KING OF PRUSSIA, PA 19406 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $338 | $0 | $338 | 9.97% |
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 | 226 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 227 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 208 | $462K |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 132 | $91K |
| Vision | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 132 | $91K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 226 | $29K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 226 | $38K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 0 | $18K |
| Other | LIFE INSURANCE COMPANY OF NORTH AMERICA | 226 | $3K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 226 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.