| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 10000 N. CENTRAL EXPY., STE 1100 DALLAS, TX 75231 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $2K | $2K | 1.54% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 10000 N. CENTRAL EXPY STE 1100 DALLAS, TX 75231 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $1K | $1K | 1.35% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 10000 N. CENTRAL EXPY STE 1100 DALLAS, TX 75231 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $782 | $782 | 1.34% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 10000 N. CENTRAL EXPY STE 1100 DALLAS, TX 75231 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $205 | $205 | 1.51% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| DELTA DENTAL EIN 23-7322578 | Contract Administrator Service code 13 | — | $23K |
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 | 425 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 10 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 437 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL | 366 | $291K |
| Vision | VISION BENEFITS OF AMERICA | 325 | $39K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 425 | $122K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 391 | $76K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 391 | $58K |
| Other | LIFE INSURANCE COMPANY OF NORTH AMERICA | 425 | $14K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 425 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.