| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES | 1420 5TH AVENUE SUITE 1500 SEATTLE, WA 98101 | REGENCE BLUE SHIELD | $498 | — | $498 | 0.15% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MOUNTAIN STATES | PO BOX 2158 RIVERSIDE, CA 925162158 | MEDICA INSURANCE COMPANY | $1K | — | $1K | 1.60% |
| STEEGE ASSOC INC3 Filed as: STEEGE AND ASSOCIATES | 2600 EAGAN WOODS DR SUITE 455 EAGAN, MN 551211169 | MEDICA INSURANCE COMPANY | $1K | — | $1K | 1.19% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INS SERVICES | SUITE 900 5444 WESTHEIMER RD HOUSTON, TX 770565306 | METROPOLITAN LIFE INSURANCE COMPANY | $1K | $288 | $1K | 3.60% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 1001 MOOREHEAD SQUARE DR SUITE 400 CHARLOTTE, NC 282030013 | METROPOLITAN LIFE INSURANCE COMPANY | $566 | — | $566 | 1.43% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 16253 COLLECTION CENTER DR. CHICAGO, IL 60693 | METROPOLITAN LIFE INSURANCE COMPANY | — | $226 | $226 | 0.57% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURNACE SEVICES | 1420 5TH AVENUE SUITE 1500 SEATTLE, WA 98101 | UNUM LIFE INSURANCE COMPANY | $759 | $101 | $860 | 11.36% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL SOUTHEAST | 2430 MALL DRIVE SUITE 280 CHARLETON, NC 29406 | UNUM LIFE INSURANCE COMPANY | $568 | $28 | $596 | 7.87% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES | 1420 5TH AVENUE SUITE 1500 SEATTLE, WA 98101 | UNUM LIFE INSURANCE COMPANY | $734 | $98 | $832 | 11.73% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL SOUTHEAST | 2430 MALL DR SUITE 280 CHARLESTON, SC 29406 | UNUM LIFE INSURANCE COMPANY | $499 | $25 | $524 | 7.39% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INC | 1001 MOREHEAD SQARE DRIVE CHARLOTTE, NC 28203 | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | $237 | — | $237 | 5.26% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT EMPLOYEE BENEFITS | 701 B STREET 6TH FLOOR SAN DIEGO, CA 92101 | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | $219 | — | $219 | 4.86% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES | 1420 5TH AVENUE SUITE 1500 SEATTLE, WA 98101 | UNUM LIFE INSURANCE COMPANY | $258 | $34 | $292 | 10.78% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTRENATIONAL SOUTHEAST | 2430 MALL DR SUITE 280 CHALESTON, NC 29406 | UNUM LIFE INSURANCE COMPANY | $194 | $10 | $204 | 7.53% |
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 | 0 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 190 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 190 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | REGENCE BLUE SHIELD | 198 | $423K |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 190 | $40K |
| Vision | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | 129 | $5K |
| Life insurance(2 contracts) | UNUM LIFE INSURANCE COMPANY | 148 | $10K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY | 38 | $8K |
| Other(2 contracts) | UNUM LIFE INSURANCE COMPANY | 148 | $10K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 198 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.