| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BLACK GOULD & ASSOCIATES INC | 3800 N CENTRAL AVE 9TH FLOOR PHOENIX, AZ 85012 | AETNA LIFE INSURANCE | $24K | $151 | $24K | 3.15% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BLACK GOULD & ASSOCIATES INC | 3800 N CENTRAL AVE 9TH FLOOR PHOENIX, AZ 85012 | SUN LIFE ASSURANCE COMPANY OF CANADA | $19K | — | $19K | 19.01% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BLACK GOULD & ASSOCIATES INC | 3800 N CENTRAL AVE 9TH FLOOR PHOENIX, AZ 85012 | UNION SECURITY INSURANCE COMPANY | $3K | $959 | $4K | 11.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BLACK GOULD & ASSOCIATES INC | 3800 N CENTRAL AVE 9TH FLOOR PHOENIX, AZ 85012 | AETNA LIFE INSURANCE (SRC) | $2K | — | $2K | 10.35% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BLACK GOULD & ASSOCIATES INC | 3800 N CENTRAL AVE 9TH FLOOR PHOENIX, AZ 85012 | UNION SECURITY INSURANCE COMPANY | $442 | $265 | $707 | 8.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BLACK GOULD & ASSOCIATES INC | 3800 N CENTRAL AVE 9TH FLOOR PHOENIX, AZ 85012 | AVESIS INSURANCE INCORPORATED | $1K | — | $1K | 13.06% |
| CENTERSTONE INSURANCE AND FINANCIAL Filed as: CENTERSTONE INS AND FINANCIAL SERVI | 12404 PARK CENTRAL DR STE 400S DALLAS, TX 75251 | METROPOLITAN LIFE INSURANCE COMPANY | $17 | — | $17 | — |
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 | 167 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 167 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | AETNA LIFE INSURANCE | 154 | $772K |
| Dental(2 contracts) | UNION SECURITY INSURANCE COMPANY | 53 | $41K |
| Vision | AVESIS INSURANCE INCORPORATED | 92 | $8K |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 167 | $103K |
| Short-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 167 | $103K |
| Long-term disability(2 contracts, 2 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 167 | $103K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 167 | — |
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.