| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL LTD | PO BOX 5099 TWIN FALLS, ID 83303 | PACIFICSOURCE HEALTH PLANS | $22K | — | $22K | 0.60% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL LTD | 157 RIVER VISTA PLACE TWIN FALLS, ID 83301 | METROPOLITAN LIFE INSURANCE COMPANY | $7K | $66 | $7K | 3.26% |
| GBS BENEFITS INS AGENCY3 | 2200 SOUTH MAIN STREET, SUITE 600 SALT LAKE CITY, UT 84115 | METROPOLITAN LIFE INSURANCE COMPANY | $496 | $0 | $496 | 0.22% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL LTD | PO BOX 2158 RIVERSIDE, CA 92516 | USABLE LIFE | $679 | $250 | $929 | 12.51% |
| GBS BENEFITS INS AGENCY3 | 2200 SOUTH MAIN STREET, SUITE 600 SALT LAKE CITY, UT 84115 | USABLE LIFE | $53 | $0 | $53 | 0.71% |
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 | 230 | 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) | 230 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | PACIFICSOURCE HEALTH PLANS | 463 | $3.6M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 769 | $224K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 769 | $224K |
| Life insurance | USABLE LIFE | 230 | $7K |
| Prescription drug | PACIFICSOURCE HEALTH PLANS | 463 | $3.6M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 769 | — |
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 comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.