| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS | — | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $41K | — | $41K | 11.42% |
| CENTERSTONE INSURANCE AND FINANCIAL3 Filed as: CENTERSTONE INS AGCY & FIN SVCS | — | CIGNA HEALTH AND LIFE INSURANCE COMPANY | — | $16K | $16K | 4.57% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS | PO BOX 2158 RIVERSIDE, CA 92516 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (CIGNA) | $12K | — | $12K | 9.90% |
| CENTERSTONE INSURANCE AND FINANCIAL3 Filed as: CENTERSTONE INS AGCY & FIN SVCS | 4851 LBJ FWY STE 100 DALLAS, TX 75244 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (CIGNA) | — | $4K | $4K | 3.34% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL OF CALI | 4371 LATHAM ST STE 101 RIVERSIDE, CA 92501 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | $148 | $3K | 15.92% |
| BENEFITMALL3 | 6200 CANOGA AVE STE 300 WOODLAND HILLS, CA 91367 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $805 | — | $805 | 5.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL OF CALI | 4371 LATHAM ST STE 101 RIVERSIDE, CA 92501 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | $153 | $2K | 15.99% |
| BENEFITMALL3 | 6200 CANOGA AVE STE 300 WOODLAND HILLS, CA 91367 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $771 | — | $771 | 5.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS | PO BOX 2158 RIVERSIDE, CA 92516 | CIGNA DENTAL HEALTH OF CALIFORNIA, INC. | $1K | — | $1K | 10.00% |
| CENTERSTONE INSURANCE AND FINANCIAL3 Filed as: CENTERSTONE INS AGCY & FIN SVCS | 4851 LBJ FWY STE 100 DALLAS, TX 75244 | CIGNA DENTAL HEALTH OF CALIFORNIA, INC. | — | $434 | $434 | 4.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL OF CALI | 4371 LATHAM ST STE 101 RIVERSIDE, CA 92501 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $215 | $11 | $226 | 15.80% |
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 | 216 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 1 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 218 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 218 | $361K |
| Dental(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (CIGNA) | 220 | $132K |
| Vision | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (CIGNA) | 220 | $121K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 290 | $16K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 290 | $15K |
| Other(2 contracts) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 290 | $18K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 290 | — |
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.