| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 9855 SCRANTON ROAD, SUITE 100 SAN DIEGO, CA 92121 | SIMNSA | $1K | — | $1K | 0.32% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 9855 SCRANTON ROAD SAN DIEGO, CA 92121 | AETNA LIFE INSURANCE CO. | $25K | $9K | $34K | 13.59% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 1591 GALBRAITH AVE SE GRAND RAPIDS, MI 49546 | HARTFORD LIFE AND ACCIDENT | — | $7K | $7K | 3.83% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 970 RESERVE DR STE 200 ROSEVILLE, CA 95678 | HARTFORD LIFE AND ACCIDENT | — | $937 | $937 | 0.53% |
| MS BENEFITS3 | 100 CHALLENGER RD RIDGEFIELD PARK, NJ 07660 | SUN LIFE ASSURANCE COMPANY OF CANADA | $22K | — | $22K | 30.18% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 3801 UNIVERSITY AVE RIVERSIDE, CA 92501 | SUN LIFE ASSURANCE COMPANY OF CANADA | $18K | — | $18K | 24.69% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 5600 NEW KING DR STE 210 TROY, MI 48098 | SUN LIFE ASSURANCE COMPANY OF CANADA | — | $4K | $4K | 5.35% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | PO BOX 2158 RIVERSIDE, CA 92516 | METROPOLITAN LIFE INSURANCE COMPANY | $4K | $590 | $4K | 11.50% |
| PLANSOURCE BENEFITS ADMINISTRATION3 Filed as: PLANSOURCE BENEFITS ADMIN INC | 122 W PINE STE STE 203 ORLANDO, FL 32801 | METROPOLITAN LIFE INSURANCE COMPANY | — | $1K | $1K | 3.02% |
| MS BENEFITS3 | 100 CHALLENGER ROAD STE 105 RIDGEFIELD PARK, NJ 07660 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $686 | — | $686 | 6.02% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 9855 SCRANTON ROAD, SUITE 100 SAN DIEGO, CA 92121 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $656 | — | $656 | 5.75% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | PO BOX 95287 CHICAGO, IL 60694 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $371 | — | $371 | 3.25% |
| SYNERGY ENROLLMENT & BENEFITS LLC3 Filed as: SYNERGY ENROLLLMENT AND BENEFITS | 3550 CAMINO DEL RIO N, STE 207 SANDIEGO, CA 92108 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $114 | — | $114 | 1.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL OF CA INS SVCS IN | 3390 UNIVERSITY AVE., SUITE 300 RIVERSIDE, CA 92501 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | — | $27 | $27 | 0.24% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | PO BOX 95287 CHICAGO, IL 60694 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $24 | — | $24 | 2.42% |
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 | 783 | 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) | 783 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | UNITEDHEALTHCARE INSURANCE COMPANY | 511 | $4.3M |
| Dental(2 contracts, 2 carriers) | SIMNSA | 612 | $668K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 702 | $39K |
| Life insurance(2 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 878 | $189K |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 878 | $177K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 878 | $177K |
| Prescription drug(2 contracts, 2 carriers) | UNITEDHEALTHCARE INSURANCE COMPANY | 511 | $4.3M |
| Other(3 contracts, 3 carriers) | HARTFORD LIFE AND ACCIDENT | 878 | $253K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 878 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.