| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST | 3011 ARMORY DRIVE SUITE 250 NASHVILLE, TN 37204 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $0 | $103K | $103K | 2.32% |
| ASSUREDPARTNERS3 Filed as: ASSUREDPARTNERS NL LLC | 800 CRESCENT DR SUITE 600 FRANKLIN, TN 37067 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | — | $75K | $75K | 1.68% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 3510 N CAUSEWAY STE 3000 METAIRIE, LA 70002 | DELTA DENTAL OF TENNESSEE | $7K | — | $7K | 2.32% |
| ASSUREDPARTNERS3 Filed as: ASSUREDPARTNERS NL LLC | 4500 TOWN CENTRE BLVD STE 200 JEFFERSONVILLE, IN 47130 | DELTA DENTAL OF TENNESSEE | $5K | — | $5K | 1.68% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL GULF SOUTH | PO BOX 2158 RIVERSIDE, CA 92516 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $16K | — | $16K | 6.35% |
| ASSUREDPARTNERS3 Filed as: ASSUREDPARTNERS NL LLC | 840 CRESCENT CENTRE DR STE 300 FRANKLIN, TN 37067 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $7K | — | $7K | 2.74% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL GULF | PO BOX 2158 RIVERSIDE, CA 92516 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $8K | — | $8K | 6.33% |
| ASSUREDPARTNERS3 Filed as: ASSUREDPARTNERS NL LLC | 840 CRESCENT CENTRE DR STE 300 FRANKLIN, TN 37067 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | — | $3K | 2.76% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL GULF | PO BOX 2158 RIVERSIDE, CA 92516 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $7K | — | $7K | 6.33% |
| ASSUREDPARTNERS3 Filed as: ASSUREDPARTNERS NL LLC | 840 CRESCENT CENTRE DR STE 300 FRANKLIN, TN 37067 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | — | $3K | 2.76% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 3011 AMORY DRIVE STE 250 NASHVILLE, TN 37204 | VISION SERVICE PLAN | $3K | — | $3K | 5.85% |
| ASSUREDPARTNERS3 Filed as: ASSUREDPARTNERS NL, LLC | 840 CRESCENT CENTRE DR STE 300 FRANKLIN, TN 37067 | VISION SERVICE PLAN | $2K | — | $2K | 4.22% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL GULF | PO BOX 2158 RIVERSIDE, CA 92516 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | — | $3K | 6.36% |
| ASSUREDPARTNERS3 Filed as: ASSUREDPARTNERS NL LLC | 840 CRESCENT CENTRE DR STE 300 FRANKLIN, TN 37067 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | — | $1K | 2.74% |
| SMITH, LAWRENCE R3 | 185 NIKKI LN PARIS, TN 38242 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $7K | — | $7K | 14.89% |
| MULTIPLE BROKERS (SEE APPENDIX)3 | 800 CRESCENT DR FRANKLIN, TN 37067 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $913 | — | $913 | 12.60% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL GULF | PO BOX 2158 RIVERSIDE, CA 92516 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $257 | $56 | $313 | 12.20% |
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 | 482 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 11 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 497 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 442 | $4.4M |
| Dental | DELTA DENTAL OF TENNESSEE | 852 | $310K |
| Vision | VISION SERVICE PLAN | 399 | $50K |
| Life insurance(2 contracts) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 482 | $250K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 484 | $124K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 484 | $118K |
| Other(6 contracts, 4 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 482 | $362K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 852 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.