| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL TX, INC | 700 N PEARL ST, STE N1700 DALLAS, TX 75201 | UNITED HEALTHCARE INSURANCE COMPANY | $8K | $61K | $70K | 1.49% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES INC | PO BOX 745977 LOS ANGELES, CA 90074 | UNITED HEALTHCARE INSURANCE COMPANY | $2K | -$2K | $270 | 0.01% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL TX, INC | 700 N PEARL ST, STE N1700 DALLAS, TX 75201 | UNITED HEALTHCARE INSURANCE COMPANY | $29K | $0 | $29K | 2.77% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES INC. | PO BOX 745977 LOS ANGELES, CA 90074 | UNITED HEALTHCARE INSURANCE COMPANY | -$792 | $0 | -$792 | -0.07% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES INC | PO BOX 745977 LOS ANGELES, CA 90074 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $1K | $1K | 3.02% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES INC | PO BOX 745977 LOS ANGELES, CA 90074 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $912 | $912 | 2.35% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES INC | PO BOX 745977 LOS ANGELES, CA 90074 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $900 | $900 | 2.38% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES INC | PO BOX 745977 LOS ANGELES, CA 90074 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $239 | $239 | 2.64% |
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 | 498 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 6 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 504 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts) | UNITED HEALTHCARE INSURANCE COMPANY | 1,139 | $5.7M |
| Dental | UNITED HEALTHCARE INSURANCE COMPANY | 1,139 | $4.7M |
| Vision | UNITED HEALTHCARE INSURANCE COMPANY | 1,139 | $4.7M |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 277 | $43K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 221 | $39K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 221 | $38K |
| Prescription drug | UNITED HEALTHCARE INSURANCE COMPANY | 1,139 | $4.7M |
| Other(2 contracts, 2 carriers) | UNITED HEALTHCARE INSURANCE COMPANY | 504 | $49K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,139 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.