| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST | 55 E JACKSON BLVD 14TH FL STE 14A CHICAGO, IL 60604 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | $3K | $4K | 3.08% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST | 55 E JACKSON BLVD 14TH FL STE 14A CHICAGO, IL 60604 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | $3K | $4K | 3.02% |
| SEQUOIA BENEFITS & INS SVCS LLC3 Filed as: SEQUOIA BENEFITS & INS SERVICES LLC | 1850 GATEWAY DR, SUITE 700 SAN MATEO, CA 94404 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $5K | — | $5K | 15.00% |
| SEQUOIA BENEFITS & INS SVCS LLC3 Filed as: SEQUOIA BENEFITS & INS SERVICES LLC | 1850 GATEWAY DR, SUITE 700 SAN MATEO, CA 94404 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $4K | — | $4K | 15.00% |
| RHONA S UNSELL INC4 | 6525 GUNPARK DRIVE STE 370-152 BOULDER, CO 80301 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $2K | — | $2K | 8.33% |
| SEQUOIA BENEFITS & INS SVCS LLC4 Filed as: SEQUOIA BENEFITS AND INS SVCS LLC | 1850 GATEWAY DR, SUITE 700 SAN MATEO, CA 94404 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $2K | — | $2K | 5.86% |
| HUB INTERNATIONAL MIDWEST LIMITED4 Filed as: HUB INTERNATIONAL MIDWEST | 55 E JACKSON BLVD 14TH FL STE 14A CHICAGO, IL 60604 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $829 | — | $829 | 2.94% |
| SEQUOIA BENEFITS & INS SVCS LLC3 Filed as: SEQUOIA BENEFITS & INS SERVICES LLC | 1850 GATEWAY DR, SUITE 700 SAN MATEO, CA 94404 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $4K | — | $4K | 15.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST | 55 E JACKSON BLVD 14TH FL STE 14A CHICAGO, IL 60604 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $103 | $331 | $434 | 1.88% |
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 | 766 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 17 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 783 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 623 | $839K |
| Vision | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 623 | $839K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 897 | $135K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 651 | $128K |
| Other(5 contracts, 3 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 901 | $140K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 901 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.