| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BLACK GOULD AND ASSOCIATES | 3800 N. CENTRAL AVE 9TH FLOOR PHOENIX, AL 85012 | BLUE CROSS BLUE SHIELD OF ARIZONA | $27K | — | $27K | 7.13% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BLACK GOULD AND ASSOCIATES | 3800 N. CENTRAL AVE. FLOOR 9 PHOENIX, AL 85012 | SUN LIFE ASSURANCE COMPANY OF CANADA | $6K | — | $6K | 12.33% |
| SHEAR BENEFITS3 Filed as: SHEAR BENEFITS INC | 14500 N NORTHSIGHT BLVD SCOTTSDALE, AZ 85260 | FIDELITY SECURITY LIFE | $594 | — | $594 | 15.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BLACK GOULD & ASSOCIATES INC | 3800 N CENTRAL AVE 9TH FL PHOENIX, AZ 85012 | MHN SERVICES, LLC | $319 | — | $319 | 9.99% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BLACK GOULD AND ASSOCIATES | 3800 N CENTRAL AVE 9TH FLOOR PHOENIX, AZ 85012 | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | $390 | — | $390 | 13.87% |
| BLUE CROSS BLUE SHIELD OF FLORIDA3 Filed as: BCBS OF ARIZONA | 2444 W LAS PALMAS DRIVE PHOENIX, AZ 85021 | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | — | $150 | $150 | 5.34% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BLACK GOULD & ASSOC | 3800 N CENTRAL AVE 9TH FL PHOENIX, AZ 85012 | HARTFORD LIFE AND ACCIDENT | -$26 | -$13 | -$39 | -15.06% |
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 | 144 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 145 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF ARIZONA | 76 | $381K |
| Dental | SUN LIFE ASSURANCE COMPANY OF CANADA | 79 | $46K |
| Vision(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF ARIZONA | 79 | $427K |
| Life insurance(3 contracts, 3 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 181 | $49K |
| Short-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 79 | $46K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 79 | $46K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF ARIZONA | 76 | $381K |
| Other(4 contracts, 4 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 181 | $54K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 181 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.