| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: FOX EVERETT- DIVISION OF HUB INTNL | 300 CONCOURSE BOULEVARD SUITE 300 RIDGELAND, MS 39157 | UNIMERICA INSURANCE COMPANY | $12K | — | $12K | 4.00% |
| ALLEGIANT GLOBAL PARTNERS3 | — | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $10K | — | $10K | 8.04% |
| THOMAS MURRAY3 | — | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $940 | — | $940 | 0.79% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: FOX-EVERETT PA | PO BOX 6006 RIDGELAND, MS 391586006 | RELIANCE STANDARD | $6K | — | $6K | 8.04% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: FOX/EVERETT PA | PO BOX 6006 RIDGELAND, MS 391586006 | RELIANCE STANDARD | $5K | — | $5K | 15.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE CO EIN 59-1031071 CONTRACT ADMINISTRATOR | Non-monetary compensation; Other services; Float revenue; Participant communication; Contract Administrator; Direct payment from the plan; Named fiduciary; Claims processing Service code 12 | — | $301K |
| FOX EVERETT A DIVISION OF HUB EIN 35-0672425 CONTRACT ADMINISTRATOR | Claims processing Service code 12 | — | $22K |
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 | 298 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 298 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 11 | $118K |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 11 | $118K |
| Life insurance | RELIANCE STANDARD | 298 | $33K |
| Long-term disability | RELIANCE STANDARD | 288 | $75K |
| Stop-loss / reinsurancereinsurance | UNIMERICA INSURANCE COMPANY | 296 | $292K |
| Other(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 298 | $151K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 298 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.