| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL TEXAS INC | 3221 COLLINSWORTH ST FORT WORTH, TX 76107 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $111K | — | $111K | 20.16% |
| KAREN TYLER-DUNN3 | 714 SEYMOUR DR FRISCO, TX 75033 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $14K | $4K | $18K | 9.20% |
| CHRISTOPHER D TYLER3 Filed as: CHRISTOPHER D. TYLER | 714 SEYMOUR DR. FRISCO, TX 75033 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $10K | $7K | $17K | 8.91% |
| AMARILIS ALTAGRACIA CSIKORTOS3 | 480 CREEK TERRACE DRIVE SAGINAW, TX 76131 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4K | $902 | $5K | 2.38% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL TEXAS INC | 3221 COLLINSWORTH ST FORT WORTH, TX 76107 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3K | — | $3K | 1.46% |
| ROBYN ANGELA SANDERS3 | 4624 WARWICK LN FRISCO, TX 75034 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $928 | $2K | 1.05% |
| PATRICIA HERNANDEZ3 | 4313 AUGUSTA DR GARLAND, TX 75041 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | — | $1K | 0.58% |
| JULIAN OLALDE3 Filed as: JULIAN GABRIEL OLALDE | 342 SAGEMEADOW RD WYLIE, TX 75098 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | — | $1K | 0.55% |
| MIRANDA JOYCE DAVIS3 | 1420 W MCDERMOTT DR, APT 928 ALLEN, TX 75013 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $891 | — | $891 | 0.46% |
| ERNESTO ELOY GARCIA3 | 1244 WILSON DR LANTANA, TX 76226 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $23 | — | $23 | 0.01% |
| CHRISTOPHER D TYLER3 Filed as: CHRISTOPHER TYLER | 714 SEYMOUR DR FRISCO, TX 75033 | UNUM LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | — | $2K | 7.70% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL TEXAS, INC. | 106 S ST MARYS ST STE 800 SAN ANTONIO, TX 78205 | UNUM LIFE INSURANCE COMPANY OF NORTH AMERICA | $696 | — | $696 | 2.30% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL TEXAS, INC. | 2924 KNIGHT ST STE 370 SHREVEPORT, LA 71105 | UNUM LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $348 | $348 | 1.15% |
| CHRISTOPHER D TYLER3 Filed as: CHRISTOPHER TYLER | 714 SEYMOUR DR FRISCO, TX 75033 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $781 | — | $781 | 7.84% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL TEXAS INC. | 106 S ST MARYS ST STE 800 SAN ANTONIO, TX 78205 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $215 | — | $215 | 2.16% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL TEXAS INC. | 2924 KNIGHT ST STE 370 SHREVEPORT, LA 71105 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $107 | $107 | 1.07% |
| CHRISTOPHER D TYLER3 Filed as: CHRISTOPHER TYLER | 714 SEYMOUR DR FRISCO, TX 75033 | UNUM LIFE INSURANCE COMPANY OF NORTH AMERICA | $584 | — | $584 | 7.75% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL TEXAS, INC. | 106 S ST MARYS ST STE 800 SAN ANTONIO, TX 78205 | UNUM LIFE INSURANCE COMPANY OF NORTH AMERICA | $169 | — | $169 | 2.24% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL TEXAS, INC. | 2924 KNIGHT ST STE 370 SHREVEPORT, LA 71105 | UNUM LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $84 | $84 | 1.12% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH & LIFE INSURANCE CO. EIN 59-1031071 CONTRACT ADMINISTRATOR | Participant communication; Other services; Claims processing; Contract Administrator; Float revenue; Non-monetary compensation; Named fiduciary; Direct payment from the plan Service code 12 | — | $88K |
| CIGNA | Direct payment from the plan; Other services; Non-monetary compensation; Contract Administrator; Float revenue; Participant communication; Claims processing; Named fiduciary Service code 12 | — | $0 |
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 | 203 | 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) | 203 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 255 | $553K |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 255 | $553K |
| Vision | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 255 | $553K |
| Life insurance(3 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 231 | $232K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 31 | $10K |
| Other(2 contracts) | UNUM LIFE INSURANCE COMPANY OF NORTH AMERICA | 231 | $38K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 255 | — |
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.