| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 4695 MACARTHUR COURT, SUITE 600 NEWPORT BEACH, CA 92660 | HEALTH NET | $85K | — | $85K | 3.79% |
| ALLIANT INSURANCE SERVICES, INC.3 | 735 EAST CARNEGIE DRIVE, SUITE 200 SAN BERNARDINO, CA 92408 | HEALTH NET | -$17 | — | -$17 | -0.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 4695 MACARTHUR COURT, SUITE 600 NEWPORT BEACH, CA 92660 | METROPOLITAN LIFE INSURANCE COMPANY | $15K | $4K | $19K | 8.05% |
| GIS BENEFITS INC3 | 422 WAUPONSEE STREET MORRIS, IL 60450 | METROPOLITAN LIFE INSURANCE COMPANY | $9K | $6K | $15K | 6.63% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS5 Filed as: BOON CHAPMAN BENEFIT ADMIN | PO BOX 9201 AUSTIN, TX 78766 | METROPOLITAN LIFE INSURANCE COMPANY | — | $9K | $9K | 3.87% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 4695 MACARTHUR COURT, SUITE 600 NEWPORT BEACH, CA 92660 | HEALTH PLAN OF NEVADA | $8K | — | $8K | 5.84% |
| DIANA LEWIS3 | 28059 US HIGHWAY 19 N, SUITE 201 CLEARWATER, FL 33761 | METROPOLITAN LIFE INSURANCE COMPANY | $16K | $564 | $16K | 37.93% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 4695 MACARTHUR COURT, SUITE 600 NEWPORT BEACH, CA 92660 | METROPOLITAN LIFE INSURANCE COMPANY | $7K | $288 | $7K | 16.36% |
| GIS BENEFITS INC3 | 422 WAUPONSEE STREET MORRIS, IL 60450 | METROPOLITAN LIFE INSURANCE COMPANY | $2K | $2K | $3K | 7.79% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS5 Filed as: BOON CHAPMAN BENEFIT ADMIN | PO BOX 9201 AUSTIN, TX 78766 | METROPOLITAN LIFE INSURANCE COMPANY | — | $2K | $2K | 4.02% |
| GIS BENEFITS INC3 | 422 WAUPONSEE STREET MORRIS, IL 60450 | SAFEGUARD HEALTH PLANS, INC. | $1K | $1K | $3K | 8.18% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 4695 MACARTHUR COURT, SUITE 600 NEWPORT BEACH, CA 92660 | SAFEGUARD HEALTH PLANS, INC. | $1K | $749 | $2K | 6.19% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS5 Filed as: BOON CHAPMAN BENEFIT ADMIN | PO BOX 9201 AUSTIN, TX 78766 | SAFEGUARD HEALTH PLANS, INC. | — | $1K | $1K | 3.96% |
| DIANA LEWIS3 | 28059 US HIGHWAY 19 N, SUITE 201 CLEARWATER, FL 33761 | METROPOLITAN LIFE INSURANCE COMPANY | $8K | $268 | $9K | 36.59% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 4695 MACARTHUR COURT, SUITE 600 NEWPORT BEACH, CA 92660 | METROPOLITAN LIFE INSURANCE COMPANY | $4K | $191 | $4K | 16.01% |
| GIS BENEFITS INC3 | 422 WAUPONSEE STREET MORRIS, IL 60450 | METROPOLITAN LIFE INSURANCE COMPANY | $925 | $1K | $2K | 8.18% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS5 Filed as: BOON CHAPMAN BENEFIT ADMIN | PO BOX 9201 AUSTIN, TX 78766 | METROPOLITAN LIFE INSURANCE COMPANY | — | $925 | $925 | 3.90% |
| DIANA LEWIS3 | 28059 US HIGHWAY 19 N, SUITE 201 CLEARWATER, FL 33761 | METROPOLITAN LIFE INSURANCE COMPANY | $9K | $287 | $9K | 40.11% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 4695 MACARTHUR COURT, SUITE 600 NEWPORT BEACH, CA 92660 | METROPOLITAN LIFE INSURANCE COMPANY | $4K | $194 | $4K | 17.51% |
| GIS BENEFITS INC3 | 422 WAUPONSEE STREET MORRIS, IL 60450 | METROPOLITAN LIFE INSURANCE COMPANY | $952 | $1K | $2K | 8.97% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS5 Filed as: BOON CHAPMAN BENEFIT ADMIN | PO BOX 9201 AUSTIN, TX 78766 | METROPOLITAN LIFE INSURANCE COMPANY | — | $952 | $952 | 4.27% |
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 | 881 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 883 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | HEALTH NET | 434 | $2.4M |
| Dental(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 695 | $266K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 695 | $232K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 695 | $232K |
| Prescription drug(2 contracts, 2 carriers) | HEALTH NET | 434 | $2.4M |
| Other(4 contracts) | METROPOLITAN LIFE INSURANCE COMPANY | 695 | $321K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 695 | — |
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.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.