| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SVCS | 7770 JEFFERSON NE SUITE 200 ALBUQUERQUE, NM 87109 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $41K | $1K | $42K | 14.62% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SVCS | 2375 E CAMELBACK RD PHOENIX, AZ 85016 | DELTA DENTAL OF NEW MEXICO INC. | $8K | — | $8K | 5.22% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SVC | 7770 JEFFERSON NE SUITE 200 ALBUQUERQUE, NM 87109 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $4K | $1K | $5K | 6.27% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SVC | 7770 JEFFERSON NE SUITE 200 ALBUQUERQUE, NM 87109 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $4K | $829 | $5K | 12.43% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SVC | 7770 JEFFERSON NE SUITE 200 ALBUQUERQUE, NM 87109 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $3K | $554 | $4K | 10.84% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SVCS | PO BOX 844663 DALLAS, TX 752844663 | VISION SERVICE PLAN | $1K | — | $1K | 5.60% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SVC | 7770 JEFFERSON NE SUITE 200 ALBUQUERQUE, NM 87109 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $413 | $62 | $475 | 11.49% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE COM EIN 59-1031071 NONE | Other services; Contract Administrator; Direct payment from the plan; Claims processing; Named fiduciary; Float revenue; Participant communication; Non-monetary compensation Service code 12 | 900 COTTAGE GROVE ROAD BLOOMFIELD, CT 06002 | $22K |
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 | 166 | 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) | 166 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 187 | $289K |
| Dental | DELTA DENTAL OF NEW MEXICO INC. | 290 | $147K |
| Vision | VISION SERVICE PLAN | 147 | $20K |
| Life insurance | RELIANCE STANDARD LIFE INSURANCE COMPANY | 166 | $80K |
| Short-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 166 | $33K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 74 | $39K |
| Other(2 contracts) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 166 | $84K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 290 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.