| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | UNKNOWN WASHINGTON, DC 20036 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $17K | — | $17K | 20.87% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| USI CONSULTING ACTUARIAL | Actuarial Service code 11 | 95 GLASTONBURY BOULEVARD GLASTONBURY, CT 06033 | $48K |
| SUNTRUST TRUST MANAGEMENT | Trustee (bank, trust company, or similar financial institution) Service code 21 | GA-ATL-210 PO BOX 4655 ATLANTA, GA 30302 | $36K |
| HUB INTERNATIONAL NE LIMITED CONSULTING | Consulting fees Service code 70 | 1065 AVENUE OF THE AMERICAS NEW YORK CITY, NY 10018 | $21K |
| GOVATOS INVESTMENT CONSULTING EIN 23-2986828 INVESTMENT CONSULTING | Investment management Service code 28 | — | $14K |
| BENEFIT ANALYSIS INC. RETIREE PLAN ADMIN | Plan Administrator Service code 14 | PO BOX 527 NUTLEY, NJ 07110 | $11K |
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 | 0 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 227 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 227 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 1 | $82K |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 1 | $82K |
| Vision | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 1 | $82K |
| Life insurance | DELAWARE AMERICAN LIFE INSURANCE COMPANY | 227 | $0 |
| Prescription drug | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 1 | $82K |
| Stop-loss / reinsurancereinsurance | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 227 | $230K |
| Other | DELAWARE AMERICAN LIFE INSURANCE COMPANY | 227 | $0 |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 227 | — |
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.