| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: FOX-EVERETT PA | 300 CONCOURSE BOULEVARD, STE 300 RIDGELAND, MS 39157 | UNIMERICA INSURANCE COMPANY | $11K | — | $11K | 4.03% |
| HUB INTERNATIONAL MIDWEST LIMITED Filed as: FOX-EVERETT PA | PO BOX 6006 RIDGELAND, MS 391586006 | RELIANCE STANDARD | $3K | — | $3K | 4.92% |
| ALLEGIANT GLOBAL PARTNERS3 | 47 WINTER STREET, STE 6 BOSTON, MA 02108 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $3K | — | $3K | 10.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: FOX-EVERETT PA | PO BOX 6006 RIDGELAND, MS 391586006 | RELIANCE STANDARD | $1K | — | $1K | 5.13% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: FOX-EVERETT PA | PO BOX 6006 RIDGELAND, MS 391586006 | RELIANCE STANDARD | $240 | — | $240 | 3.72% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE CO EIN 59-1031071 CONTRACT ADMINISTRATOR | Participant communication; Float revenue; Claims processing; Non-monetary compensation; Named fiduciary; Other services; Contract Administrator; Direct payment from the plan Service code 12 | — | $280K |
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 | 301 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 301 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 1 | $30K |
| Long-term disability | RELIANCE STANDARD | 299 | $51K |
| Stop-loss / reinsurancereinsurance | UNIMERICA INSURANCE COMPANY | 263 | $285K |
| Other(2 contracts) | RELIANCE STANDARD | 299 | $30K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 299 | — |
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."
No prospect flags tripped on this filing.