| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 5110 MARYLAND WAY, SUITE 250 BRENTWOOD, TN 37027 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | — | $46K | $46K | 5.82% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 5110 MARYLAND WAY, SUITE 250 BRENTWOOD, TN 37027 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | — | $4K | $4K | 0.51% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 2120 PEWAUKEE RD, SUITE 202 WAUKESHA, WI 53188 | COMMUNITY INSURANCE COMPANY | $5K | — | $5K | 8.68% |
| BENEFITS NETWORK INSURANCE AGENCY3 | 4555 LAKE FOREST DRIVE, SUITE 510 CINCINNATI, OH 45242 | COMMUNITY INSURANCE COMPANY | — | $2K | $2K | 3.76% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SVCS | PO BOX 3310 SANTA BARBARA, CA 93130 | COMMUNITY INSURANCE COMPANY | — | $1K | $1K | 1.91% |
| MARGARET M. COLLIGNON3 Filed as: MARGARET COLLIGNON | 5110 MARYLAND WAY, SUITE 250 BRENTWOOD, TN 37027 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $5K | — | $5K | 11.65% |
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 | 129 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 131 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 123 | $788K |
| Dental | COMMUNITY INSURANCE COMPANY | 138 | $61K |
| Vision | COMMUNITY INSURANCE COMPANY | 138 | $61K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 129 | $39K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 129 | $39K |
| Prescription drug | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 123 | $788K |
| Other | UNUM LIFE INSURANCE COMPANY OF AMERICA | 129 | $39K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 138 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.