| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BLACK GOULD & ASSOCIATES | 9TH FLOOR 3800 N CENTRAL AVE PHOENIX, AZ 85012 | BLUE CROSS BLUE SHIELD OF ARIZONA | $58K | — | $58K | 7.10% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BLACK GOULD & ASSOCIATES INC | 3800 N CENTRAL AVE, 9TH FLOOR PHOENIX, AZ 85012 | AMERICAN NATIONAL INSURANCE COMPANY OF TEXAS | $6K | — | $6K | 11.69% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BLACK GOULD & ASSOC INC | 3800 N CENTRAL AVE 9TH FL PHOENIX, AZ 85012 | SUN LIFE ASSURANCE COMPANY OF CANADA | $284 | — | $284 | 11.92% |
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 | 175 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 175 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF ARIZONA | 163 | $816K |
| Dental | AMERICAN NATIONAL INSURANCE COMPANY OF TEXAS | 149 | $52K |
| Vision | AMERICAN NATIONAL INSURANCE COMPANY OF TEXAS | 149 | $52K |
| Life insurance(2 contracts, 2 carriers) | AMERICAN NATIONAL INSURANCE COMPANY OF TEXAS | 149 | $55K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF ARIZONA | 163 | $816K |
| Other | SUN LIFE ASSURANCE COMPANY OF CANADA | 29 | $2K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 163 | — |
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.