| 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 | $0 | $3K | $3K | 0.27% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC | PO BOX 5435 RIVERSIDE, CA 92517 | SUN LIFE ASSURANCE COMPANY OF CANADA | — | $13K | $13K | 3.56% |
| 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 | $4K | — | $4K | 1.08% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL SERVICES, INC. | PO BOX 3135 ALBUQUERQUE, NM 87190 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $9K | — | $9K | 9.48% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INS CO EIN 59-1031071 CONTRACT ADMINISTRATOR | Participant communication; Float revenue; Claims processing; Non-monetary compensation; Contract Administrator; Named fiduciary; Other services; Direct payment from the plan Service code 12 | — | $113K |
| CANOPY EIN 93-0774210 EAP PROVIDER | Direct payment from the plan Service code 50 | — | $35K |
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 | 750 | 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) | 750 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 780 | $969K |
| Dental | DELTA DENTAL OF NEW MEXICO | 1,112 | $348K |
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY | 1,067 | $90K |
| Life insurance(2 contracts) | SUN LIFE ASSURANCE COMPANY OF CANADA | 750 | $737K |
| Short-term disability(2 contracts) | SUN LIFE ASSURANCE COMPANY OF CANADA | 750 | $737K |
| Long-term disability(2 contracts) | SUN LIFE ASSURANCE COMPANY OF CANADA | 750 | $737K |
| Other(2 contracts) | SUN LIFE ASSURANCE COMPANY OF CANADA | 750 | $737K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,112 | — |
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."
No prospect flags tripped on this filing.