| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL TEXAS, INC. | PO BOX 2158 RIVERSIDE, CA 92516 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $18K | — | $18K | 10.11% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 18201 VON KARMAN AVENUE IRVINE, CA 92612 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $9K | — | $9K | 4.89% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $2K | $2K | 1.37% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL TEXAS, INC. | PO BOX 2158 RIVERSIDE, CA 92516 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $17K | — | $17K | 10.05% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 18201 VON KARMAN AVENUE IRVINE, CA 92612 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $8K | — | $8K | 4.95% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $2K | $2K | 1.33% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL TEXAS, INC. | PO BOX 2158 RIVERSIDE, CA 92516 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $9K | — | $9K | 10.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 18201 VON KARMAN AVENUE IRVINE, CA 92612 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $5K | — | $5K | 5.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $1K | $1K | 1.39% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 GOLF RD ROLLING MEADOWS, IL 60008 | VISION SERVICE PLAN | $806 | — | $806 | 1.07% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL TEXAS, INC | 3221 COLLINSWORTH ST FORT WORTH, TX 76107 | VISION SERVICE PLAN | $802 | — | $802 | 1.07% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | P.O. BOX 2158 RIVERSIDE, CA 92516 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $6K | — | $6K | 11.65% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 GOLF RD ROLLING MEADOWS, IL 60008 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $5K | — | $5K | 8.34% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | P.O. BOX 2158 RIVERSIDE, CA 92516 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $4K | — | $4K | 11.73% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 GOLF RD ROLLING MEADOWS, IL 60008 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $3K | — | $3K | 8.06% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | P.O. BOX 2158 RIVERSIDE, CA 92516 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $3K | — | $3K | 11.70% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 GOLF RD ROLLING MEADOWS, IL 60008 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $2K | — | $2K | 8.41% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL TEXAS, INC. | PO BOX 2158 RIVERSIDE, CA 92516 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | — | $2K | 9.99% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 18201 VON KARMAN AVENUE IRVINE, CA 92612 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $832 | — | $832 | 5.01% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $277 | $277 | 1.67% |
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 | 909 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 5 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 914 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (CIGNA) | 97 | $351K |
| Vision | VISION SERVICE PLAN | 631 | $75K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 985 | $174K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,033 | $170K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 200 | $95K |
| Other(5 contracts, 3 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 1,485 | $155K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,485 | — |
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.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.