| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | 3390 UNIVERSITY AVENUE RIVERSIDE, CA 92501 | AETNA LIFE INSURANCE COMPANY | $0 | $26K | $26K | 4.84% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 4350 WEST CYPRESS STREET TAMPA, FL 33607 | AETNA LIFE INSURANCE COMPANY | $0 | $2K | $2K | 0.42% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | PO BOX 2158 RIVERSIDE, CA 92516 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $6K | $0 | $6K | 8.21% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $2K | $2K | 3.06% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 200 SOUTH ORANGE AVENUE SUITE 1350 ORLANDO, FL 32801 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $0 | $1K | 1.79% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2056 VISTA PARKWAY, SUITE 300 WEST PALM BEACH, FL 33411 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $16K | $0 | $16K | 38.35% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $0 | $81 | $81 | 0.19% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 200 SOUTH ORANGE AVENUE SUITE 1350 ORLANDO, FL 32801 | FLORIDA COMBINED LIFE | $4K | $0 | $4K | 9.41% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $42 | $1K | 9.12% |
| HELEN DIZ-HATTON3 | 8251 GREENSBORO DRIVE MCLAINE, VA 22012 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $758 | $499 | $1K | 7.78% |
| SUFINANZA INSURANCE AND FINANCIAL S3 Filed as: SUFINANZA INS & FIN & OTHER AGENTS | 3351 NORTHWEST 85TH AVENUE CORAL SPRINGS, FL 33065 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $367 | $106 | $473 | 2.93% |
| JACK ALLEN NORRIS3 | 2439 DUTCH BRANCH ROAD COLUMBIA, SC 29210 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $187 | $36 | $223 | 1.38% |
| THE GRANT AGENCY INC3 | PO BOX 41544 JACKSONVILLE, FL 32203 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $155 | $4 | $159 | 0.98% |
| JERRY LYNN MCMILLIAN SR3 | 5514 BARRINGTON COURT JACKSONVILLE, FL 32244 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $155 | $0 | $155 | 0.96% |
| MAGDA ISABEL WISDOM3 | 2453 WILLOW PARK ROAD BETHLEHEM, PA 18020 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $117 | $0 | $117 | 0.72% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | 4695 MACARTHUR COURT, SUITE 600 NEWPORT BEACH, CA 92660 | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | $1K | $0 | $1K | 9.26% |
| ACRISURE LLC3 | 100 OTTAWA AVENUE SOUTHWEST GRAND RAPIDS, MI 49503 | USABLE LIFE | $309 | $0 | $309 | 5.09% |
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 | 83 | 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) | 83 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | AETNA LIFE INSURANCE COMPANY | 102 | $543K |
| Dental | FLORIDA COMBINED LIFE | 105 | $38K |
| Vision | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | 98 | $12K |
| Life insurance(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 80 | $114K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 80 | $71K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 80 | $71K |
| Prescription drug | AETNA LIFE INSURANCE COMPANY | 102 | $543K |
| Other(4 contracts, 4 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 113 | $136K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 113 | — |
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.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.