| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SERVICES | 6565 AMERICAS PKWY NE STE 720 ALBUQUERQUE, NM 87110 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | — | $8K | $8K | 0.62% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC | 2000 S COLORADO BLVD TOWER 2 SUITE 150 DENVER, CO 80222 | SUN LIFE ASSURANCE COMPANY OF CANADA | — | $8K | $8K | 1.30% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC | 3390 UNIVERSITY AVE SUITE 300 RIVERSIDE, CA 92501 | SUN LIFE ASSURANCE COMPANY OF CANADA | $185 | — | $185 | 0.03% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INS CO EIN 59-1031071 CONTRACT ADMINISTRATOR | Contract Administrator; Participant communication; Named fiduciary; Claims processing; Non-monetary compensation; Direct payment from the plan; Float revenue; Other services Service code 12 | — | $128K |
| CANOPY EIN 93-0774210 EAP PROVIDER | Direct payment from the plan Service code 50 | — | $21K |
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 | 724 | 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) | 724 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 496 | $1.3M |
| Dental | DELTA DENTAL OF NEW MEXICO | 1,002 | $312K |
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY | 956 | $88K |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 724 | $583K |
| Short-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 724 | $583K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 724 | $583K |
| Other | SUN LIFE ASSURANCE COMPANY OF CANADA | 724 | $583K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,002 | — |
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.