| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | 600 CLEVELAND STREET, SUITE 600 CLEARWATER, FL 33755 | CONTINENTAL AMERICAN INSURANCE COMPANY | $53K | — | $53K | 25.00% |
| SHANNON HERNANDEZ3 | 7131 CREEK DRIVE NEW PORT RICHEY, FL 34655 | CONTINENTAL AMERICAN INSURANCE COMPANY | $33K | — | $33K | 15.59% |
| KATHRYN S. AXENTE AND OTHER AGENTS3 | 8313 WEST HILLSBOROUGH, SUITE 150 TAMPA, FL 33615 | CONTINENTAL AMERICAN INSURANCE COMPANY | $12K | — | $12K | 5.45% |
| JOSEPH P TOTH3 Filed as: JOSEPH P. TOTH | 4625 FM 2920 BOX 141 SPRING, TX 77388 | CONTINENTAL AMERICAN INSURANCE COMPANY | $5K | — | $5K | 2.22% |
| MICHAEL LEFFLER3 Filed as: MICHAEL G. LEFFLER | PO BOX 27 SAUGERTIES, NY 12477 | CONTINENTAL AMERICAN INSURANCE COMPANY | $3K | — | $3K | 1.47% |
| TRAVIS B MOREHEAD3 Filed as: TRAVIS MOREHEAD | 7131 CREEK DRIVE NEW PORT RICHEY, FL 34655 | CONTINENTAL AMERICAN INSURANCE COMPANY | $3K | — | $3K | 1.21% |
| KELLEY A GULLION3 Filed as: KELLEY A. GULLION | 13718 COOPER ROAD SORING HILL, FL 34609 | CONTINENTAL AMERICAN INSURANCE COMPANY | $2K | — | $2K | 1.18% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | 600 CLEVELAND STREET, SUITE 600 CLEARWATER, FL 33755 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | $4K | $7K | 5.46% |
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 | 415 | 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) | 415 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 684 | $925K |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 684 | $925K |
| Vision | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 684 | $925K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 415 | $133K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 415 | $133K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 415 | $133K |
| Prescription drug | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 684 | $925K |
| Other(2 contracts, 2 carriers) | CONTINENTAL AMERICAN INSURANCE COMPANY | 415 | $345K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 684 | — |
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.