| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL TEXAS, INC. | 10000 N CENTRAL EXPY STE 1200 DALLAS, TX 75231 | BLUE CROSS BLUE SHEILD OF TEXAS | $58K | $1K | $59K | 5.76% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL TEXAS INC | 10000 NORTH CENTRAL EXPRESSWAY SUITE 1200 DALLAS, TX 75231 | PRINCIPAL LIFE INSURANCE COMPANY | $6K | $0 | $6K | 10.00% |
| GIS BENEFITS INC3 | 422 WAUPONSEE ST MORRIS, IL 60450 | PRINCIPAL LIFE INSURANCE COMPANY | $0 | $5K | $5K | 8.13% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL LIMITED | 150 N RIVERSIDE PLZ STE 1700 CHICAGO, IL 60606 | PRINCIPAL LIFE INSURANCE COMPANY | $0 | $2K | $2K | 4.13% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL TEXAS, INC | 3221 COLLINSWORTH ST FORT WORTH, TX 76107 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | $0 | $1K | 10.47% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS | 422 WAUPONSEE ST MORRIS, IL 60450 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $654 | $654 | 5.23% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS3 | PO BOX 9201 AUSTIN, TX 78766 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $646 | $0 | $646 | 5.16% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL TEXAS, INC | 2924 KNIGHT ST STE 370 SHREVEPORT, LA 71105 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $2 | $2 | 0.02% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL TEXAS, INC | 3221 COLLINSWORTH ST FORT WORTH, TX 76107 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | $0 | $1K | 10.62% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS | 422 WAUPONSEE ST MORRIS, IL 60450 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $615 | $615 | 5.28% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS3 | PO BOX 9201 AUSTIN, TX 78766 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $608 | $0 | $608 | 5.22% |
| BOON CHAPMAN BNFT ADMNSTRS INC3 | — | ESMS INOVA LLC | $136 | $0 | $136 | 25.00% |
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 | 168 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 7 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 175 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHEILD OF TEXAS | 155 | $1.0M |
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 146 | $56K |
| Vision | PRINCIPAL LIFE INSURANCE COMPANY | 146 | $56K |
| Life insurance | ESMS INOVA LLC | 3 | $544 |
| Short-term disability | ESMS INOVA LLC | 3 | $544 |
| Long-term disability | ESMS INOVA LLC | 3 | $544 |
| Other(3 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 53 | $25K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 155 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.