| 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. | $127K | — | $127K | 9.10% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | PO BOX 6650 METAIRIE, LA 70009 | DELTA DENTAL OF TENNESSEE | $32K | — | $32K | 10.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | PO BOX 2158 RIVERSIDE, CA 92516 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $22K | $3K | $24K | 16.77% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | PO BOX 2158 RIVERSIDE, CA 92516 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $16K | $2K | $18K | 16.81% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | PO BOX 2158 RIVERSIDE, CA 92516 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $15K | $2K | $17K | 17.02% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 55 E. JACKSON CHICAGO, IL 60604 | NATIONAL VISION ADMINISTRATORS, LLC | $5K | — | $5K | 10.00% |
| THOMAS CHRISTOPHER SMITH3 Filed as: THOMAS SMITH | 2928 FOSTER CREIGHTON DR. NASHVILLE, TN 37204 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $8K | $576 | $8K | 18.17% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 5110 MARYLAND WAY, SUITE 250 BRENTWOOD, TN 37027 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $131 | — | $131 | 0.29% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | PO BOX 2158 RIVERSIDE, CA 92516 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | $402 | $3K | 17.13% |
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 | 688 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 5 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 693 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | 940 | $1.4M |
| Dental | DELTA DENTAL OF TENNESSEE | 1,061 | $323K |
| Vision | NATIONAL VISION ADMINISTRATORS, LLC | 888 | $49K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 950 | $107K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 295 | $98K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 249 | $145K |
| Prescription drug | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | 940 | $1.4M |
| Other(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 688 | $64K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,061 | — |
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.