| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 | 3635 RIVERSIDE PLAZA DRIVE SUITE 300 RIVERSIDE, CA 92506 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $12K | — | $12K | 20.59% |
| IMG3 | 2960 NORTH MERIDIAN STREET INDIANAPOLIS, IN 46208 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $23 | $23 | 0.04% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 55 EAST JACKSON BOULEVARD FLOOR 14 CHICAGO, IL 60604 | CONTINENTAL AMERICAN INSURANCE COMPANY | $913 | — | $913 | 5.35% |
| VICTORIA MCVAY3 Filed as: VICTORIA R MCVAY | 711 NATCHEZ TRAIL COURT MOBILE, AL 36609 | CONTINENTAL AMERICAN INSURANCE COMPANY | $764 | — | $764 | 4.48% |
| BOZEMAN ENTERPRISES INC3 | 4 YACHT CLUB DRIVE SUITE 206 DALPHNE, AL 36526 | CONTINENTAL AMERICAN INSURANCE COMPANY | $217 | — | $217 | 1.27% |
| SARAH YOUNCE ZACCARO3 | 2854 BRAIRFIELD LANE MOBILE, AL 36693 | CONTINENTAL AMERICAN INSURANCE COMPANY | $200 | — | $200 | 1.17% |
| MICHAEL S MASKILL3 | 12375 RIVER CREEK LOT 10 FAIRHOPE, AL 36532 | CONTINENTAL AMERICAN INSURANCE COMPANY | $135 | — | $135 | 0.79% |
| TINA C OGLESBY3 Filed as: TINA CATHERINE OGLESBY | 3194 GATES CIRCLE NORTH THEODORE, AL 36582 | CONTINENTAL AMERICAN INSURANCE COMPANY | $36 | — | $36 | 0.21% |
| ESTATE OF RONALD WALLACE3 | 17243C NORTH LAKE DRIVE BAY MINETTE, AL 36507 | CONTINENTAL AMERICAN INSURANCE COMPANY | $27 | — | $27 | 0.16% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | PO BOX 2167 GRAND RAPIDS, MI 49501 | PRINCIPAL LIFE INSURANCE COMPANY | $529 | — | $529 | 9.99% |
| GIS BENEFITS INC3 | 422 WAUPONSEE STREET MORRIS, IL 60450 | PRINCIPAL LIFE INSURANCE COMPANY | — | $356 | $356 | 6.73% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL LIMITED | 150 NORTH RIVERSIDE PLAZA SUITE 1700 CHICAGO, IL 60606 | PRINCIPAL LIFE INSURANCE COMPANY | — | $318 | $318 | 6.01% |
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 | 107 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 107 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS AND BLUE SHIELD OF ALABAMA | 65 | $758K |
| Vision | PRINCIPAL LIFE INSURANCE COMPANY | 49 | $5K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 109 | $57K |
| Short-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 109 | $57K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 109 | $57K |
| Prescription drug | BLUE CROSS AND BLUE SHIELD OF ALABAMA | 65 | $758K |
| Other(3 contracts, 3 carriers) | BLUE CROSS AND BLUE SHIELD OF ALABAMA | 109 | $833K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 109 | — |
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.