| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | 3390 UNIVERSITY AVENUE, SUITE 300 RIVERSIDE, CA 92501 | AMERITAS LIFE INSURANCE CORP. | $7K | $0 | $7K | 10.43% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | 75 WEST TOWNE RIDGE PARKWAY TOWER 2, SUITE 400 SANDY, UT 84070 | HARTFORD LIFE AND ACCIDENT | $9K | $0 | $9K | 28.02% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | 970 RESERVE DRIVE, SUITE 200 ROSEVILLE, GA 95678 | HARTFORD LIFE AND ACCIDENT | $0 | $1K | $1K | 3.48% |
| ACRISURE LLC4 Filed as: ORION PARKER | 65 NORTH 100 WEST HURRICANE, UT 84737 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $513 | $0 | $513 | 20.32% |
| HUB INTERNATIONAL MIDWEST LIMITED4 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | PO BOX 2158 RIVERSIDE, CA 92516 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $191 | $0 | $191 | 7.57% |
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 | 182 | 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) | 182 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | AMERITAS LIFE INSURANCE CORP. | 283 | $63K |
| Vision | AMERITAS LIFE INSURANCE CORP. | 283 | $63K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 182 | $34K |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 182 | $34K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 182 | $34K |
| Other(2 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 182 | $36K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 283 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.