| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL OF CA INS SVCS | 6701 CENTER DRIVE, SUITE 1500 LOS ANGELES, CA 90045 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $57K | $474 | $57K | 14.49% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTL OF CA INS. SVCES., INC. | 3390 UNIVERSITY AVENUE SUITE 300 RIVERSIDE, CA 92501 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $23K | -$1K | $22K | 18.61% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | 3390 UNIVERSITY AVENUE SUITE 300 RIVERSIDE, CA 92501 | AETNA LIFE INSURANCE COMPANY | $10K | $0 | $10K | 10.56% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL OF CALI | 6701 CENTER DRIVE WEST SUITE 1500 LOS ANGELES, CA 90045 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | $2K | $4K | 21.75% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | 3390 UNIVERSITY AVENUE SUITE 300 RIVERSIDE, CA 92501 | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY | $2K | -$354 | $2K | 14.74% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | 6701 CENTER DRIVE WEST SUITE 1500 LOS ANGELES, CA 90045 | ACE AMERICAN INSURANCE COMPANY | $1K | $0 | $1K | 15.00% |
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 | 104 | 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) | 104 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 138 | $494K |
| Dental | AETNA LIFE INSURANCE COMPANY | 17 | $97K |
| Vision | AETNA LIFE INSURANCE COMPANY | 17 | $97K |
| Life insurance(2 contracts, 2 carriers) | AETNA LIFE INSURANCE COMPANY | 104 | $114K |
| Short-term disability(2 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 104 | $17K |
| Long-term disability(3 contracts, 3 carriers) | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 104 | $148K |
| Prescription drug(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 138 | $494K |
| Other(3 contracts, 3 carriers) | AETNA LIFE INSURANCE COMPANY | 104 | $121K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 138 | — |
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.