| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | 3390 UNIVERSITY AVENUE, SUITE 300 RIVERSIDE, CA 92501 | AETNA LIFE INSURANCE COMPANY | $361K | $11K | $372K | 3.72% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | 9595 WILSHIRE BOULEVARD, SUITE 801 BEVERELY HILLS, CA 90212 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $370K | $25K | $395K | 51.63% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | 9595 WILSHIRE BOULEVARD SUITE 801 BEVERLY HILLS, CA 90212 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $31K | $8K | $40K | 5.21% |
| FMLA SOURCE INC3 Filed as: FMLA SOURCE, INC. | 455 NORTH CITYFRONT PLAZA DRIVE 13TH FLOOR CHICAGO, IL 60611 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $13K | $13K | 1.74% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | 3390 UNIVERSITY AVENUE, SUITE 300 RIVERSIDE, CA 92501 | AETNA LIFE INSURANCE COMPANY | $16K | $19K | $35K | 7.12% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | PO BOX 2158 RIVERSIDE, CA 92516 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $100 | $18 | $118 | 1.18% |
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 | 859 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 33 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 892 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 2 carriers) | AETNA LIFE INSURANCE COMPANY | 1,432 | $10.5M |
| Dental(2 contracts, 2 carriers) | AETNA LIFE INSURANCE COMPANY | 1,432 | $10.0M |
| Vision | AETNA LIFE INSURANCE COMPANY | 1,432 | $10.0M |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 859 | $765K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 859 | $765K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 859 | $765K |
| Prescription drug(3 contracts, 2 carriers) | AETNA LIFE INSURANCE COMPANY | 1,432 | $10.5M |
| Other(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 859 | $775K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,432 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.