| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | 3390 RIVERSIDE AVENUE SUITE 300 RIVERSIDE, CA 92501 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $77K | $0 | $77K | 3.43% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | 333 WEST EL CAMINO REAL SUITE 330 SUNNYVALE, CA 94087 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $56K | $0 | $56K | 2.49% |
| EXECUTIVE FINANCIAL BENE-FACTS INC3 Filed as: EXECUTIVE FINANCIAL | 4601 WILSHIRE BOULEVARD SUITE 200 LOS ANGELES, CA 90010 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | -$68 | $2K | $2K | 0.08% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | PO BOX 2158 RIVERSIDE, CA 92516 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $13K | $0 | $13K | 10.16% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | 3390 UNIVERSITY AVENUE SUITE 300 RIVERSIDE, CA 92501 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $3K | $3K | 2.03% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | 4371 LATHAM STREET SUITE 101 RIVERSIDE, CA 92501 | EYEMED VISION CARE | $1K | $0 | $1K | 8.16% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | 390 UNIVERSITY AVENUE SUITE 300 RIVERSIDE, CA 92501 | EYEMED VISION CARE | $140 | $0 | $140 | 0.91% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | PO BOX 2158 RIVERSIDE, CA 92516 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | $0 | $1K | 9.02% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | 3390 UNIVERSITY AVENUE SUITE 300 RIVERSIDE, CA 92501 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $268 | $268 | 1.80% |
| EXECUTIVE FINANCIAL BENE-FACTS INC3 Filed as: EXECUTIVE FINANCIAL | 4601 WILSHIRE BOULEVARD, 3RD FLOOR LOS ANGELES, CA 90010 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $605 | $0 | $605 | 10.00% |
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 | 148 | 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) | 148 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 140 | $2.2M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 140 | $2.2M |
| Vision | EYEMED VISION CARE | 335 | $15K |
| Life insurance(3 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 148 | $152K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 141 | $131K |
| Prescription drug | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 140 | $2.2M |
| Other(3 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 148 | $152K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 335 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
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.