| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | PO BOX 2158 RIVERSIDE, CA 92516 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $0 | $7K | $7K | 1.39% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | PO BOX 2158 RIVERSIDE, CA 92516 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | $10K | $13K | 3.80% |
| AON CONSULTING INC3 Filed as: AON CONSULTING | 200 EAST RANDOLPH STREET CHICAGO, IL 60601 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $343 | $343 | 0.10% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | 3390 UNIVERSITY AVENUE, SUITE 300 RIVERSIDE, CA 92501 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | $6K | $0 | $6K | 6.78% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | PO BOX 2158 RIVERSIDE, CA 92516 | RELIASTAR LIFE INSURANCE COMPANY | $11K | $0 | $11K | 23.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | 6701 CENTER DRIVE WEST, SUITE 1500 LOS ANGELES, CA 90045 | RELIASTAR LIFE INSURANCE COMPANY | $1K | $0 | $1K | 2.97% |
| PLANSOURCE BENEFITS ADMINISTRATION3 Filed as: PLANSOURCE BENEFITS ADMIN., INC. | 101 SOUTH GARLAND AVENUE, SUITE 203 ORLANDO, FL 32801 | RELIASTAR LIFE INSURANCE COMPANY | $0 | $447 | $447 | 0.94% |
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 | 1,065 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 31 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,099 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 873 | $524K |
| Vision | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | 1,389 | $88K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 551 | $351K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 551 | $351K |
| Other(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 551 | $398K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,389 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.