| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 | 3510 NORTH CAUSEWAY BOULEVARD SUITE 300 METAIRIE, LA 70002 | CIGNA HALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $69K | $0 | $69K | 7.53% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL GULF SOUTH | 7906 PLAYERS FOREST DRIVE SUITE 1 MEMPHIS, IL 38119 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $15K | $0 | $15K | 16.68% |
| GIS BENEFITS INC3 | 422 WAUPONSEE STREET MORRIS, IL 60450 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $5K | $2K | $6K | 6.79% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 3510 NORTH CAUSEWAY BOULEVARD SUITE 300 METAIRIE, LA 70002 | DELTA DENTAL OF TENNESSEE | $6K | $0 | $6K | 10.00% |
| DORA DASILVA3 Filed as: DORA R. DA SILVA | 7906 PLAYERS FOREST DRIVE MEMPHIS, IL 38119 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $8K | $0 | $8K | 19.07% |
| GIS BENEFITS INC3 | 422 WAUPONSEE STREET MORRIS, IL 60450 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $0 | $3K | $3K | 7.88% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS3 Filed as: BOON CHAPMAN BENEFITS ADMIN INC | PO BOX 9039 AUSTIN, TX 78766 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $0 | $2K | $2K | 4.77% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST LTD | 55 EAST JACKSON, 12TH FLOOR CHICAGO, IL 60604 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $0 | $2K | $2K | 4.36% |
| EDWIN W BARNETT3 Filed as: EDWIN W. BARNETT | 7906 PLAYERS FOREST DRIVE SUITE 1 MEMPHIS, TN 38119 | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | $2K | $0 | $2K | 9.34% |
| DORA DASILVA3 | 3339 GALLERY DRIVE MEMPHIS, TN 38125 | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | $145 | $0 | $145 | 0.78% |
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 | 362 | 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) | 362 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 186 | $915K |
| Dental | DELTA DENTAL OF TENNESSEE | 271 | $61K |
| Vision | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | 226 | $19K |
| Life insurance | RELIANCE STANDARD LIFE INSURANCE COMPANY | 362 | $91K |
| Short-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 104 | $41K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 362 | $91K |
| Prescription drug | CIGNA HALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 186 | $915K |
| Other | RELIANCE STANDARD LIFE INSURANCE COMPANY | 362 | $91K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 362 | — |
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.