| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 | 5110 MARYLAND WAY, SUITE 250 BRENTWOOD, TN 37027 | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | $85K | — | $85K | 3.26% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | PO BOX 6650 METAIRIE, LA 70009 | DELTA DENTAL OF TENNESSEE | $26K | — | $26K | 10.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | PO BOX 2158 RIVERSIDE, CA 92516 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $14K | $1K | $16K | 16.34% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | PO BOX 2158 RIVERSIDE, CA 92516 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $11K | $998 | $12K | 16.31% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | PO BOX 2158 RIVERSIDE, CA 92516 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $11K | $1K | $12K | 16.52% |
| THOMAS CHRISTOPHER SMITH3 Filed as: THOMAS SMITH | 2928 FOSTER CREIGHTON DR. NASHVILLE, TN 37204 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $5K | $323 | $6K | 14.80% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 55 E. JACKSON CHICAGO, IL 60604 | NATIONAL VISION ADMINISTRATORS, LLC | $3K | — | $3K | 10.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | PO BOX 2158 RIVERSIDE, CA 92516 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | $183 | $2K | 16.25% |
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 | 648 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 6 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 654 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | 848 | $2.6M |
| Dental | DELTA DENTAL OF TENNESSEE | 989 | $262K |
| Vision | NATIONAL VISION ADMINISTRATORS, LLC | 770 | $34K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 912 | $76K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 260 | $72K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 240 | $95K |
| Prescription drug | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | 848 | $2.6M |
| Other(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 896 | $52K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 989 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.