| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 9855 SCRANTON ROAD, SUITE 100 SAN DIEGO, CA 92121 | AETNA LIFE INSURANCE COMPANY | $24K | $2K | $26K | 6.35% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 9855 SCRANTON ROAD, SUITE 100 SAN DIEGO, CA 92121 | AETNA HEALTH OF CALIFORNIA INC | $13K | — | $13K | 4.42% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 9855 SCRANTON ROAD, SUITE 100 SAN DIEGO, CA 92121 | KAISER FOUNDATION HEALTH PLAN INC. | $11K | $372 | $12K | 5.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 9855 SCRANTON ROAD, SUITE 100 SAN DIEGO, CA 92121 | KAISER FOUNDATION HEALTH PLAN INC. | $5K | $202 | $5K | 5.19% |
| VARIOUS - SEE ATTACHED3 Filed as: VARIOUS-SEE ATTACHED | C/O AFLAC 1932 WYNNTON ROAD COLUMBUS, GA 31999 | AFLAC | $3K | $24 | $3K | 11.64% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 9855 SCRANTON ROAD, SUITE 100 SAN DIEGO, CA 92121 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $3K | $1K | $4K | 20.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 9855 SCRANTON ROAD, SUITE 100 SAN DIEGO, CA 92121 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $2K | $543 | $2K | 19.99% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 9855 SCRANTON ROAD, SUITE 100 SAN DIEGO, CA 92121 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $221 | $74 | $295 | 20.03% |
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 | 109 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 111 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 3 carriers) | AETNA LIFE INSURANCE COMPANY | 130 | $1.0M |
| Dental | AETNA LIFE INSURANCE COMPANY | 130 | $415K |
| Vision | AETNA LIFE INSURANCE COMPANY | 130 | $415K |
| Life insurance(2 contracts, 2 carriers) | AFLAC | 116 | $40K |
| Short-term disability | AFLAC | 28 | $29K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 33 | $22K |
| Prescription drug(4 contracts, 3 carriers) | AETNA LIFE INSURANCE COMPANY | 130 | $1.0M |
| Other(3 contracts, 2 carriers) | AFLAC | 116 | $41K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 130 | — |
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.