| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CBIZ BENEFITS & INSURANCE SERVICES3 | PO BOX 632886 CINCINNATI, OH 452632886 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $8K | $21K | $28K | 1.95% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL LIMITED | 1560 ORANGE AVE SUITE 750 WINTER PARK, FL 32789 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $2K | $5K | $7K | 0.48% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 1560 ORANGE AVENUE SUITE 750 WINTER PARK, FL 327895552 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | — | $2K | $2K | 0.14% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INS SERVICES INC. | PO BOX 632886 CINCINNATI, OH 45263 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $4K | — | $4K | 6.15% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 1560 N ORANGE AVE SUITE 750 WINTER PARK, FL 32789 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | — | $1K | 2.31% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 55 E JACKSON BLVD 14TH FLOOR, SUITE 14A CHICAGO, IL 60604 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $1K | $1K | 1.83% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS LLC | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $884 | — | $884 | 1.54% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INS SERVICES INC. | PO BOX 632886 CINCINNATI, OH 45263 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | — | $2K | 5.97% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 1560 ORANGE AVE SUITE 750 WINTER PARK, FL 32789 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | — | $1K | 2.54% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 55 E JACKSON BLVD. 14TH FLOOR, SUITE 14A CHICAGO, IL 60604 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $824 | $824 | 2.05% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS LLC | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $600 | — | $600 | 1.49% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INS SERVICES, INC. | PO BOX 632886 CINCINNATI, OH 452632886 | HARTFORD LIFE AND ACCIDENT | $5K | — | $5K | 15.18% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 1560 ORANGE AVE SUITE 750 WINTER PARK, FL 32789 | HARTFORD LIFE AND ACCIDENT | $1K | $428 | $2K | 6.20% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INS SERVICES INC. | PO BOX 632886 CINCINNATI, OH 45263 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | — | $1K | 6.13% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL FLORIDA | 1560 N ORANGE AVE SUITE 750 WINTER PARK, FL 32789 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $475 | — | $475 | 2.34% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 55 E JACKSON BLVD. 14TH FLOOR, SUITE 14A CHICAGO, IL 60604 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $389 | $389 | 1.92% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS LLC | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $311 | — | $311 | 1.53% |
| STEVE BAKER4 | 153 ESTHER DR COCOA BEACH, FL 32931 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $859 | — | $859 | 16.50% |
| TAMMY S. GIBBS4 | 311 DARROW AVE MELBOURNE, FL 32901 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $32 | — | $32 | 0.61% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INS SERVICES INC. | PO BOX 632886 CINCINNATI, OH 45263 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $310 | — | $310 | 6.15% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL FLORIDA | 1560 N ORANGE AVE SUITE 750 WINTER PARK, FL 32789 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $117 | — | $117 | 2.32% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS LLC | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $78 | — | $78 | 1.55% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 55 E JACKSON BLVD. 14TH FLOOR, SUITE 14A CHICAGO, IL 60604 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $49 | $49 | 0.97% |
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 | 0 | 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) | 0 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 201 | $1.5M |
| Dental(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 201 | $1.5M |
| Vision | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 201 | $1.5M |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 178 | $57K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 60 | $20K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 178 | $40K |
| Prescription drug(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 201 | $1.5M |
| Other(5 contracts, 4 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 178 | $109K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 201 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Final-filing indicator set. Plan is winding down; don't waste sales effort here.