| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BENEFIT COMMERCE GROUP | 16220 N SCOTTSDALE RD. STE 100 SCOTTSDALE, AZ 85254 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $17K | — | $17K | 14.76% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: DICKERSON EMPLOYEE BENEFITS | 1918 DICKERSON DR. LOS ANGELES, CA 90039 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | — | $6K | $6K | 4.86% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BENEFIT COMMERCE GROUP | 16220 N SCOTTSDALE RD. STE 100 SCOTTSDALE, AZ 85254 | PRINCIPAL LIFE INSURANCE COMPANY | $8K | $3K | $11K | 20.01% |
| GCG FINANCIAL LLC3 Filed as: ALERA GROUP, INC. | 965 GREENTREE RD. STE 110 PITTSBURGH, PA 15220 | PRINCIPAL LIFE INSURANCE COMPANY | — | $840 | $840 | 1.59% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ASSURED PARTNERS GSA NATIONAL EIN 36-4829385 CONTRACT ADMINISTRATOR | Direct payment from the plan; Other services; Contract Administrator; Recordkeeping fees; Other fees Service code 13 | — | $44K |
| CIGNA HEALTH AND LIFE INSURANCE CO. EIN 59-1031071 NONE | Non-monetary compensation; Direct payment from the plan; Named fiduciary; Contract Administrator; Claims processing; Participant communication; Float revenue; Other services Service code 12 | — | $27K |
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 | 179 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 179 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 57 | $114K |
| Dental(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 92 | $166K |
| Vision | PRINCIPAL LIFE INSURANCE COMPANY | 92 | $53K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 92 | $53K |
| Short-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 92 | $53K |
| Long-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 92 | $53K |
| Stop-loss / reinsurancereinsurance | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 57 | $114K |
| Other | ASSURITY LIFE INSURANCE COMPANY | 0 | $21K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 92 | — |
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.