| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 6701 CENTER DRIVE WEST, SUITE 1500 LOS ANGELES, CA 90045 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $232K | $38K | $270K | 7.31% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 6701 CENTER DRIVE W, SUITE 1500 LOS ANGELES, CA 90045 | CIGNA HEALTHCARE OF CALIFORNIA | $58K | — | $58K | 5.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 6701 CENTER DRIVE WEST, SUITE 1500 LOS ANGELES, CA 90045 | KAISER FOUNDATION HEALTH PLAN INC. | $30K | $827 | $31K | 5.48% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 6701 CENTER DRIVE WEST, SUITE 1500 LOS ANGELES, CA 90045 | KAISER FOUNDATION HEALTH PLAN INC. | $13K | $319 | $13K | 5.65% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 6701 CENTER DRIVE WEST, SUITE 1500 LOS ANGELES, CA 90045 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $20K | $9K | $29K | 14.21% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 6701 CENTER DRIVE WEST, SUITE 1500 LOS ANGELES, CA 90045 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $18K | $5K | $23K | 19.01% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 6701 CENTER DRIVE WEST, SUITE 1500 LOS ANGELES, CA 90045 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $14K | $4K | $18K | 19.37% |
| VARIOUS - SEE ATTACHED3 Filed as: CONTINENTAL AMERICAN - SEE ATTACHED | PO BOX 427 COLUMBIA, SC 29202 | CONTINENTAL AMERICAN INSURANCE COMPANY | $18K | — | $18K | 21.19% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 6701 CENTER DRIVE WEST, SUITE 1500 LOS ANGELES, CA 90045 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $459 | $134 | $593 | 19.39% |
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 | 783 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 20 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 803 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(5 contracts, 4 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 1,171 | $5.7M |
| Dental(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 1,171 | $3.8M |
| Vision | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 1,171 | $3.7M |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 783 | $121K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 392 | $91K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 769 | $204K |
| Prescription drug(5 contracts, 4 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 1,171 | $5.7M |
| Other(2 contracts, 2 carriers) | CONTINENTAL AMERICAN INSURANCE COMPANY | 783 | $88K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,171 | — |
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.