| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SVCS | 2000 S COLORADO BLVD STE 150 DENVER, CO 80222 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $149K | $3K | $152K | 16.78% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SVCS | 6565 AMERICAS PKWY NW, SUITE 720 ALBUQUERQUE, NM 87110 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $13K | $10K | $23K | 8.54% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SVCS | 580 N BANK LN LAKE FOREST, IL 60045 | DELTA DENTAL OF NEW MEXICO | $8K | — | $8K | 5.72% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SVCS | 6565 AMERICAS PKWY NE, SUITE 720 ALBUQUERQUE, NM 87110 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $6K | $2K | $8K | 19.98% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC | PO BOX 2158 RIVERSIDE, CA 925162158 | VISION SERVICE PLAN | $2K | — | $2K | 4.25% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INS COMPANY EIN 59-1031071 ADMINISTRATOR | Contract Administrator; Direct payment from the plan; Non-monetary compensation; Claims processing; Float revenue; Other services; Participant communication Service code 12 | — | $84K |
| CIGNA | Non-monetary compensation; Direct payment from the plan; Contract Administrator; Other services; Participant communication; Claims processing; Float revenue Service code 12 | — | $0 |
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 | 321 | 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) | 321 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 225 | $906K |
| Dental | DELTA DENTAL OF NEW MEXICO | 521 | $148K |
| Vision | VISION SERVICE PLAN | 251 | $37K |
| Life insurance(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 321 | $306K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 321 | $265K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 321 | $265K |
| Other(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 321 | $306K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 521 | — |
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.