| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST | 777 SW 37TH AVE STE 500 MIAMI, FL 33135 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $43K | $0 | $43K | 14.89% |
| MARSH & MCLENNAN AGENCY LLC3 | 1000 CORPORATE DRIVE SUITE 400 FORT LAUDERDALE, FL 33334 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $4K | $0 | $4K | 1.43% |
| MARK S METTILLE3 | 107 CANDLELIGHT LANE MORRIS, IL 60450 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $10K | $0 | $10K | 16.67% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL FLORIDA | 1330 LADY STREET SUITE 202 COLUMBIA, SC 29201 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $5K | $2K | $7K | 12.30% |
| MARSH & MCLENNAN AGENCY LLC3 | 1000 CORPORATE DRIVE SUITE 400 FORT LAUDERDALE, FL 33334 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $955 | $0 | $955 | 1.67% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWESTT | AND VARIOUS OTHER BROKERS 3510 N CAUSEWAY BLVD STE 300 METAIRIE, LA 70002 | TRANSAMERICA LIFE INSURANCE COMPANY | $4K | $0 | $4K | 10.43% |
| EXCELSIOR BENEFITS LLC3 | 23505 SMITHTOWN RD SUITE 200 EXCELSIOR, MN 55331 | TRANSAMERICA LIFE INSURANCE COMPANY | $771 | $0 | $771 | 1.84% |
| DSM FINANCIAL LLC3 | SUITE 3007 950 PENINSULA CORPORATE CIRCLE BOCA RATON, FL 33487 | TRANSAMERICA LIFE INSURANCE COMPANY | $248 | $0 | $248 | 0.59% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST | 777 SW 37TH AVE STE 500 MIAMI, FL 33135 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | $304 | $2K | 10.03% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST | 777 SW 37TH AVE STE 500 MIAMI, FL 33135 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $861 | $137 | $998 | 9.98% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST | 777 SW 37TH AVE STE 500 MIAMI, FL 33135 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $633 | $194 | $827 | 10.04% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST | 777 SW 37TH AVE STE 500 MIAMI, FL 33135 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $502 | $119 | $621 | 10.31% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST | 777 SW 37TH AVE STE 500 MIAMI, FL 33135 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $57 | $12 | $69 | 9.57% |
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 | 125 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 125 | 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 | 114 | $330K |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 78 | $57K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 78 | $57K |
| Life insurance(2 contracts) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 125 | $27K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 56 | $10K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 125 | $8K |
| Other(2 contracts) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 125 | $22K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 125 | — |
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.