| 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 | BLUE CROSS OF CALIFORNIA | $13K | $936 | $14K | 3.42% |
| MARSH & MCLENNAN AGENCY LLC3 | 9171 TOWNE CENTRE DRIVE, SUITE 100 SAN DIEGO, CA 92122 | BLUE CROSS OF CALIFORNIA | $14K | $205 | $14K | 3.27% |
| MARSH & MCLENNAN AGENCY LLC3 | 9171 TOWNE CENTRE DRIVE, SUITE 100 SAN DIEGO, CA 92122 | SIMNSA | $12K | — | $12K | 5.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 9855 SCRANTON ROAD, SUITE 100 SAN DIEGO, CA 92121 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | $370 | $3K | 16.04% |
| GIS BENEFITS INC3 | 422 WAUPONSEE STREET MORRIS, IL 60450 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $926 | — | $926 | 5.00% |
| BENEPORT LLC3 Filed as: BENEPORT | 28069 US HWY 19, SUITE 201 CLEARWATER, FL 33761 | COMBINED INSURANCE | $457 | — | $457 | 2.73% |
| DESSO FORMAN3 Filed as: DESSO H FOREMAN | 28069 US HWY 19, SUITE 201 CLEARWATER, FL 33761 | COMBINED INSURANCE | $444 | — | $444 | 2.65% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 9855 SCRANTON ROAD, SUITE 100 SAN DIEGO, CA 92121 | COMBINED INSURANCE | $396 | — | $396 | 2.37% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS INC. | 422 WAUPNOSEE STREET MORRIS, IL 60450 | COMBINED INSURANCE | $238 | — | $238 | 1.42% |
| DIANA LEWIS3 | 1928 BRAE MOOR DRIVE DUNWDIN, FL 33761 | COMBINED INSURANCE | $5 | — | $5 | 0.03% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS | 422 WAUPONSEE ST MORRIS, IL 60450 | STARMOUNT LIFE INSURANCE COMPANY | $1K | $430 | $2K | 19.88% |
| MARSH & MCLENNAN AGENCY LLC3 | 9171 TOWNE CENTRE DRIVE, SUITE 100 SAN DIEGO, CA 92122 | STARMOUNT LIFE INSURANCE COMPANY | $792 | $132 | $924 | 9.89% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 9855 SCRANTON ROAD, SUITE 100 SAN DIEGO, CA 92121 | STARMOUNT LIFE INSURANCE COMPANY | $328 | $55 | $383 | 4.10% |
| MARSH & MCLENNAN AGENCY LLC3 | 9171 TOWNE CENTRE DRIVE, SUITE 100 SAN DIEGO, CA 92122 | UNITED CONCORDIA INSURANCE COMPANY | $548 | — | $548 | 6.48% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 9855 SCRANTON ROAD, SUITE 100 SAN DIEGO, CT 92121 | UNITED CONCORDIA INSURANCE COMPANY | $292 | $146 | $438 | 5.18% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 9855 SCRANTON ROAD, SUITE 100 SAN DIEGO, CA 92121 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $247 | $17 | $264 | 3.43% |
| MARSH & MCLENNAN AGENCY LLC3 | 9171 TOWNE CENTRE DRIVE, SUITE 100 SAN DIEGO, CA 92122 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $248 | $4 | $252 | 3.27% |
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 | 152 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 152 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 112 | $656K |
| Dental(2 contracts, 2 carriers) | SIMNSA | 112 | $243K |
| Vision | STARMOUNT LIFE INSURANCE COMPANY | 57 | $9K |
| Life insurance(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 154 | $26K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 10 | $19K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 10 | $19K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 112 | $656K |
| Other(3 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 154 | $43K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 154 | — |
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.