| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHEAST | 100 SUNNYSIDE BLVD SUITE 400 WOODBURY, NY 11797 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $61K | — | $61K | 10.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHEAST | 100 SUNNYSIDE BLVD SUITE 400 WOODBURY, NY 11797 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $31K | — | $31K | 15.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWDEST 672425 | 55 E JACKSON BLVD 14TH FL ST 14A CHICAGO, IL 60604 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $19K | — | $19K | 15.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHEAST | 100 SUNNYSIDE BLVD SUITE 400 WOODBURY, NY 11797 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $8K | — | $8K | 10.00% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH AND BENEFIT LLC | 1166 AVENUE OF THE AMERICAS 22F NEW YORK, NY 10036 | FEDERAL INSURANCE COMPANY | $3K | — | $3K | 25.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE CO EIN 59-1031071 NONE | Contract Administrator; Other services; Float revenue; Claims processing; Non-monetary compensation; Named fiduciary; Participant communication; Direct payment from the plan Service code 12 | — | $721K |
| CIGNA BEHAVIORAL HEALTH, INC EIN 41-1648670 CONTRACT ADMINISTRATOR | Participant communication; Direct payment from the plan; Contract Administrator; Claims processing Service code 12 | — | $17K |
| HUB INTERNATIONAL MIDWEST LTD BROKER | Other commissions; Insurance agents and brokers Service code 22 | 55 E JACKSON BLVD CHICAGO, IL 60604 | $14K |
| CIGNA | Claims processing; Direct payment from the plan; Contract Administrator; Float revenue; Other services; Named fiduciary; Participant communication; Non-monetary compensation Service code 12 | — | $0 |
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 | 740 | 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) | 740 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 740 | $611K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 740 | $205K |
| Other(4 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 740 | $828K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 740 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.