| 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 | BLUE CROSS OF CALIFORNIA | $135K | $7K | $142K | 5.24% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 4695 MACARTHUR COURT, SUITE 600 NEWPORT BEACH, CA 92660 | METROPOLITAN LIFE INSURANCE COMPANY | $31K | $14K | $45K | 11.63% |
| GIS BENEFITS INC3 | 422 WAUPONSEE STREET MORRIS, IL 60450 | METROPOLITAN LIFE INSURANCE COMPANY | $19K | $7K | $26K | 6.76% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS5 Filed as: BOON CHAPMAN BENEFIT ADMIN | PO BOX 9201 AUSTIN, TX 78766 | METROPOLITAN LIFE INSURANCE COMPANY | — | $19K | $19K | 5.01% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 4695 MACARTHUR COURT, SUITE 600 NEWPORT BEACH, CA 92660 | HEALTH PLAN OF NEVADA | $15K | — | $15K | 6.12% |
| DESSO FORMAN3 | 28059 US HWY 19 N, SUITE 201 CLEARWATER, FL 33761 | METROPOLITAN LIFE INSURANCE COMPANY | $8K | — | $8K | 12.27% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 4695 MACARTHUR COURT, SUITE 600 NEWPORT BEACH, CA 92660 | METROPOLITAN LIFE INSURANCE COMPANY | $3K | $2K | $5K | 8.15% |
| GIS BENEFITS INC3 | 422 WAUPONSEE STREET MORRIS, IL 60450 | METROPOLITAN LIFE INSURANCE COMPANY | $3K | $1K | $4K | 6.79% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS5 Filed as: BOON CHAPMAN BENEFIT ADMIN | PO BOX 9201 AUSTIN, TX 78766 | METROPOLITAN LIFE INSURANCE COMPANY | — | $3K | $3K | 5.03% |
| DESSO FORMAN3 | 28059 US HWY 19 N, SUITE 201 CLEARWATER, FL 33761 | METROPOLITAN LIFE INSURANCE COMPANY | $7K | — | $7K | 11.38% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 4695 MACARTHUR COURT, SUITE 600 NEWPORT BEACH, CA 92660 | METROPOLITAN LIFE INSURANCE COMPANY | $3K | $2K | $5K | 7.63% |
| GIS BENEFITS INC3 | 422 WAUPONSEE STREET MORRIS, IL 60450 | METROPOLITAN LIFE INSURANCE COMPANY | $3K | $1K | $4K | 6.67% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS5 Filed as: BOON CHAPMAN BENEFIT ADMIN | PO BOX 9201 AUSTIN, TX 78766 | METROPOLITAN LIFE INSURANCE COMPANY | — | $3K | $3K | 4.99% |
| DESSO FORMAN3 | 28059 US HWY 19 N, SUITE 201 CLEARWATER, FL 33761 | METROPOLITAN LIFE INSURANCE COMPANY | $6K | — | $6K | 12.23% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 4695 MACARTHUR COURT, SUITE 600 NEWPORT BEACH, CA 92660 | METROPOLITAN LIFE INSURANCE COMPANY | $3K | $1K | $4K | 8.07% |
| GIS BENEFITS INC3 | 422 WAUPONSEE STREET MORRIS, IL 60450 | METROPOLITAN LIFE INSURANCE COMPANY | $3K | $868 | $3K | 6.71% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS5 Filed as: BOON CHAPMAN BENEFIT ADMIN | PO BOX 9201 AUSTIN, TX 78766 | METROPOLITAN LIFE INSURANCE COMPANY | — | $3K | $3K | 5.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 4695 MACARTHUR COURT, SUITE 600 NEWPORT BEACH, CA 92660 | SAFEGUARD HEALTH PLANS, INC. | $2K | $2K | $4K | 8.75% |
| GIS BENEFITS INC3 | 422 WAUPONSEE STREET MORRIS, IL 60450 | SAFEGUARD HEALTH PLANS, INC. | $2K | $828 | $3K | 6.90% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS5 Filed as: BOON CHAPMAN BENEFIT ADMIN | PO BOX 9201 AUSTIN, TX 78766 | SAFEGUARD HEALTH PLANS, INC. | — | $2K | $2K | 5.07% |
| DESSO FORMAN3 | 28059 US HWY 19 N, SUITE 201 CLEARWATER, FL 33761 | METROPOLITAN LIFE INSURANCE COMPANY | $2K | — | $2K | 9.25% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 4695 MACARTHUR COURT, SUITE 600 NEWPORT BEACH, CA 92660 | METROPOLITAN LIFE INSURANCE COMPANY | $878 | $554 | $1K | 6.47% |
| GIS BENEFITS INC3 | 422 WAUPONSEE STREET MORRIS, IL 60450 | METROPOLITAN LIFE INSURANCE COMPANY | $1K | $343 | $1K | 6.36% |
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 | 1,280 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,283 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 535 | $3.0M |
| Dental(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 1,637 | $428K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 1,637 | $383K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 1,637 | $383K |
| Short-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 102 | $22K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 535 | $3.0M |
| Other(4 contracts) | METROPOLITAN LIFE INSURANCE COMPANY | 1,637 | $559K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,637 | — |
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.