| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL TEXAS INC | 10000 N CENTRAL EXPY STE 1200 DALLAS, TX 752312371 | PRINCIPAL LIFE INSURANCE COMPANY | $23K | — | $23K | 14.85% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL LIMITED | 150 N RIVERSIDE PLZ STE 1700 CHICAGO, IL 606061572 | PRINCIPAL LIFE INSURANCE COMPANY | — | $5K | $5K | 3.19% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL TEXAS INC | 10000 N CENTRAL EXPY STE 1200 DALLAS, TX 752312371 | PRINCIPAL LIFE INSURANCE COMPANY | $21K | — | $21K | 14.55% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL LIMITED | 150 N RIVERSIDE PLZ STE 1700 CHICAGO, IL 606061572 | PRINCIPAL LIFE INSURANCE COMPANY | — | $8K | $8K | 5.24% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BOON-CHAPMAN EIN 75-1501015 MEDICAL ADMIN CHARGES | Contract Administrator Service code 13 | PO BOX 9201 AUSTIN, TX 78766 | $101K |
| AETNA SIGNATURE EIN 06-6033492 NETWORK ACCESS | Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $21K |
| HUB INTERNATIONAL TEXAS, INC. EIN 75-3243028 PLAN ADMINISTRATOR | Plan Administrator Service code 14 | 1800 W LOOP 281 STE 302 LONGVIEW, TX 756042516 | $15K |
| TELADOC HEALTH MEDICAL GROUP PA EIN 20-1020949 TELEHEALTH SERVICES | Other services Service code 49 | 1945 LAKEPOINTE DR STE 100 LEWISVILLE, TX 750576470 | $5K |
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 | 80 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 5 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 85 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance(2 contracts) | PRINCIPAL LIFE INSURANCE COMPANY | 112 | $302K |
| Short-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 112 | $145K |
| Long-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 112 | $145K |
| Stop-loss / reinsurancereinsurance | HCC LIFE INSURANCE COMPANY | 83 | $857K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 112 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.