| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BLACK GOULD & ASSOC | 3800 N CENTRAL AVE FL 9 PHOENIX, AZ 85012 | BLUE CROSS BLUE SHIELD OF ARIZONA | $74K | — | $74K | 6.83% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BLACK GOULD & ASSOC | 3800 N CENTRAL AVE FL 9 PHOENIX, AZ 85012 | HARTFORD LIFE AND ACCIDENT | $2K | $1K | $4K | 15.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BLACK GOULD & ASSOC | 3800 N CENTRAL AVE FL 9 PHOENIX, AZ 85012 | TOTAL DENTAL ADMINISTRATORS HEALTH PLANS | $2K | — | $2K | 7.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BLACK GOULD & ASSOC | 3800 N CENTRAL AVE FL 9 PHOENIX, AZ 85012 | HUMANA INSURANCE COMPANY | $2K | — | $2K | 8.44% |
| ENROLLEASE3 | 7979 OLD GEORGETOWN ROAD SUITE 300 BETHESDA, MD 20814 | HUMANA INSURANCE COMPANY | $1K | — | $1K | 5.47% |
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 | 290 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 290 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF ARIZONA | 198 | $1.1M |
| Dental(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF ARIZONA | 198 | $1.1M |
| Vision | HUMANA INSURANCE COMPANY | 162 | $19K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF ARIZONA | 198 | $1.1M |
| Other | HARTFORD LIFE AND ACCIDENT | 75 | $24K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 198 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
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.