| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| SISCO3 | 800 MAIN STREET DUBUQUE, IA 52004 | BERKLEY ACCIDENT & HEALTH | — | — | $0 | 0.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INT'L MOUNTAIN STATES LTD | P.O. BOX 2158 RIVERSIDE, CA 92516 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $5K | — | $5K | 15.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INT'L MOUNTAIN STATES LTD | P.O. BOX 2158 RIVERSIDE, CA 92516 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $3K | — | $3K | 13.92% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INT'L MOUNTAIN STATES LTD | P.O. BOX 2158 RIVERSIDE, CA 92516 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $3K | — | $3K | 15.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INT'L MOUNTAIN STATES LTD | P.O. BOX 2158 RIVERSIDE, CA 92516 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $2K | — | $2K | 8.58% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INT'L MOUNTAIN STATES LTD | P.O. BOX 2158 RIVERSIDE, CA 92516 | NATIONAL GUARDIAN LIFE INSURANCE CO. | $1K | — | $1K | 9.80% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INT'L MOUNTAIN STATES LTD | P.O. BOX 2158 RIVERSIDE, CA 92516 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $594 | — | $594 | 15.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INT'L MOUNTAIN STATES LTD | P.O. BOX 2158 RIVERSIDE, CA 92516 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $560 | — | $560 | 15.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INT'L MOUNTAIN STATES LTD | P.O. BOX 2158 RIVERSIDE, CA 92516 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $252 | — | $252 | 14.98% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INT'L MOUNTAIN STATES LTD | P.O. BOX 2158 RIVERSIDE, CA 92516 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $198 | — | $198 | 15.03% |
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 | 113 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 116 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | NATIONAL GUARDIAN LIFE INSURANCE CO. | 83 | $14K |
| Life insurance(3 contracts) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 124 | $41K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 124 | $21K |
| Stop-loss / reinsurancereinsurance | BERKLEY ACCIDENT & HEALTH | 105 | $426K |
| Other(6 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 130 | $63K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 130 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.