| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SERVICE | 8777 N. GAINEY CENTER DRIVE SUITE 100 SCOTTSDALE, AZ 85258 | DELTA DENTAL OF NEW JERSEY, INC. | $96K | — | $96K | 10.70% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SERVICE | 8777 N. GAINEY CENTER DRIVE SUITE 100 SCOTTSDALE, AZ 85258 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $11K | — | $11K | 2.44% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SERVICE | 8777 N. GAINEY CENTER DRIVE SUITE 100 SCOTTSDALE, AZ 85258 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $8K | — | $8K | 2.59% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SERVICE | 8777 N. GAINEY CENTER DRIVE SUITE 100 SCOTTSDALE, AZ 85258 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $8K | — | $8K | 2.57% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SERVICE | 8777 N. GAINEY CENTER DRIVE SUITE 100 SCOTTSDALE, AZ 85258 | CAPITAL ADVANTAGE ASSURANCE COMPANY | $3K | — | $3K | 1.39% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SERVICE | 8777 N. GAINEY CENTER DRIVE SUITE 100 SCOTTSDALE, AZ 85258 | METROPOLITAN LIFE INSURANCE COMPANY | $12K | $47 | $12K | 6.70% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SERVICE | 8777 N. GAINEY CENTER DRIVE SUITE 100 SCOTTSDALE, AZ 85258 | METROPOLITAN LIFE INSURANCE COMPANY | $6K | $3K | $9K | 5.02% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SERVICE | 8777 N. GAINEY CENTER DRIVE SUITE 100 SCOTTSDALE, AZ 85258 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | — | $3K | 2.44% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SERVICE | 8777 N. GAINEY CENTER DRIVE SUITE 100 SCOTTSDALE, AZ 85258 | ALPHA DENTAL PROGRAMS, INC. | $5K | — | $5K | 10.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SERVICE | 8777 N. GAINEY CENTER DRIVE SUITE 100 SCOTTSDALE, AZ 85258 | NEW YORK LIFE GROUP INSURANCE COMPANY OF NEW YORK | $2K | — | $2K | 9.99% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HORIZON HEALTHCARE SERVICES, INC. EIN 22-0999690 NONE | Direct payment from the plan; Contract Administrator Service code 13 | — | $516K |
| HUB INTERNATIONAL INSURANCE SVC NONE | Direct payment from the plan; Insurance agents and brokers Service code 22 | 8777 N. GAINEY CENTER DRIVE STE 100 SCOTTSDALE, AZ 85258 | $41K |
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 | 989 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 992 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KEYSTONE HEALTH PLAN EAST | 4 | $80K |
| Dental(2 contracts, 2 carriers) | DELTA DENTAL OF NEW JERSEY, INC. | 1,697 | $948K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 2,409 | $177K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,557 | $465K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,532 | $325K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,100 | $306K |
| Prescription drug | CAPITAL ADVANTAGE ASSURANCE COMPANY | 25 | $201K |
| Other(2 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,557 | $140K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,409 | — |
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.