| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 | 3510 N. CAUSEWAY BLVD., SUITE 300 METAIRIE, LA 70002 | DELTA DENTAL OF TENNESSEE | $11K | — | $11K | 4.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | PO BOX 2158 RIVERSIDE, CA 92516 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $26K | $4K | $30K | 11.69% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | PO BOX 2158 RIVERSIDE, CA 92516 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $11K | $2K | $13K | 11.73% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | PO BOX 2158 RIVERSIDE, CA 92516 | LIFE INSURANCE COMPANY OF AMERICA | $10K | $2K | $12K | 11.72% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | PO BOX 2158 RIVERSIDE, CA 92516 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $5K | $851 | $5K | 11.84% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | PO BOX 6650 METAIRIE, LA 70009 | VISION SERVICE PLAN | $4K | — | $4K | 9.15% |
| LAWRENCE R. SMITH3 | 1397 E BLUE CREEK RD WAVERLY, TN 37185 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4K | — | $4K | 15.00% |
| LAWRENCE R. SMITH3 | 1397 EAST BLUE CREEK ROAD WAVERLY, TN 37185 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | — | $3K | 16.22% |
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 | 422 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 6 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 428 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 1 | $0 |
| Dental | DELTA DENTAL OF TENNESSEE | 811 | $276K |
| Vision | VISION SERVICE PLAN | 380 | $45K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 602 | $259K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 422 | $110K |
| Long-term disability | LIFE INSURANCE COMPANY OF AMERICA | 422 | $104K |
| Other(3 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 595 | $96K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 811 | — |
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.