| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BENEFIT COMMERCE GROUP LLC | 16220 N SCOTTSDALE RD. STE 100 SCOTTSDALE, AZ 85254 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $20K | — | $20K | 16.99% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: DICKERSON EMPLOYEE BENEFITS | 1918 DICKERSON DR. LOS ANGELES, CA 90039 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | — | $7K | $7K | 5.59% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BENEFIT COMMERCE GROUP | 16220 N SCOTTSDALE RD. STE 100 SCOTTSDALE, AZ 85254 | PRINCIPAL LIFE INSURANCE COMPANY | $4K | $838 | $5K | 12.36% |
| GCG FINANCIAL LLC3 Filed as: ALERA GROUP, INC. | 965 GREENTREE RD. STE 110 PITTSBURGH, PA 15220 | PRINCIPAL LIFE INSURANCE COMPANY | — | $426 | $426 | 1.15% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BENEFIT COMMERCE GROUP LLC | 14300 N NORTHSIGHT BLVD STE 221 SCOTTSDALE, AZ 85260 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | — | $2K | 9.30% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BENEFIT COMMERCE GROUP LLC | 14300 N NORTHSIGHT BLVD. STE 221 SCOTTSDALE, AZ 85260 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $458 | — | $458 | 3.77% |
| AXIM GLOBAL STRATEGIES GROUP3 Filed as: AXIM GLOBAL STRATEGIES GROUP LLC | 8925 W POST RD STE 105 LAS VEGAS, NV 89148 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $121 | — | $121 | 1.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BENEFIT COMMERCE GROUP LLC | 14300 N NORTHSIGHT BLVD. STE 221 SCOTTSDALE, AZ 85260 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $766 | — | $766 | 8.22% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BENEFIT COMMERCE GROUP LLC | 14300 N NORTHSIGHT BLVD. STE 221 SCOTTSDALE, AZ 85260 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $688 | — | $688 | 10.10% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BENEFIT COMMERCE GROUP LLC | 14300 N NORTHSIGHT BLVD. STE 221 SCOTTSDALE, AZ 85260 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $86 | — | $86 | 23.43% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ASSURED PARTNERS GSA NATIONAL EIN 36-4829385 CONTRACT ADMIN | Contract Administrator; Recordkeeping fees; Other fees; Other services; Direct payment from the plan Service code 13 | — | $51K |
| CIGNA HEALTH AND LIFE INSURANCE CO. EIN 59-1031071 NONE | Claims processing; Contract Administrator; Float revenue; Participant communication; Named fiduciary; Non-monetary compensation; Direct payment from the plan; Other services Service code 12 | — | $28K |
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 | 129 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 129 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 63 | $117K |
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 81 | $37K |
| Vision | PRINCIPAL LIFE INSURANCE COMPANY | 81 | $37K |
| Life insurance(2 contracts) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 69 | $16K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 69 | $12K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 69 | $17K |
| Stop-loss / reinsurancereinsurance | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 63 | $117K |
| Other(2 contracts, 2 carriers) | ASSURITY LIFE INSURANCE COMPANY | 69 | $22K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 81 | — |
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.