| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED Filed as: BLACK GOULD & ASSOCIATES | — | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $31K | $12K | $43K | 10.90% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BLACK BOULD & ASSOCIATES | 3800 N CENTRAL AVE 9TH FL PHOENIX, AZ 85012 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $6K | $2K | $8K | 13.93% |
| HUB INTERNATIONAL MIDWEST LIMITED Filed as: BENEFIT COMMERCE GROUP LLC | 14300 N NORTHSIGHT BLVD SCOTTSDALE, AZ 85260 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | $0 | $2K | 10.00% |
| HUB INTERNATIONAL MIDWEST LIMITED Filed as: BLACK GOULD & ASSOCIATES INC | 3800 N CENTRAL AVE 9TH FL PHOENIX, AZ 85012 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $1K | $1K | 5.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BLACK GOULD & ASSOCIATES | 3800 N CENTRAL AVE FL 9 PHOENIX, AZ 85012 | UNION SECURITY INSURANCE COMPANY | $4K | $0 | $4K | 20.01% |
| HUB INTERNATIONAL MIDWEST LIMITED Filed as: BENEFIT COMMERCE GROUP | 14300 N NORTHSIGHT BLVD SCOTTSDALE, AZ 85260 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $216 | $0 | $216 | 9.97% |
| HUB INTERNATIONAL MIDWEST LIMITED Filed as: BLACK GOULD & ASSOCIATES INC | 3800 N CENTRAL AVE 9TH FL PHOENIX, AZ 85012 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $108 | $108 | 4.98% |
| ASHLEY INSURANCE GROUP Filed as: ASHLEY BOEHLER | — | ASSURITY LIFE INSURANCE COMPANY | $589 | — | $589 | 43.99% |
| HUB INTERNATIONAL MIDWEST LIMITED Filed as: BENEFIT COMMERCE GROUP | — | ASSURITY LIFE INSURANCE COMPANY | $489 | — | $489 | 36.52% |
| FILIPE COELHO | — | ASSURITY LIFE INSURANCE COMPANY | $407 | — | $407 | 30.40% |
| Z.RAE INSURANCE GROUP Filed as: Z RAE INSURANCE GROUP | — | ASSURITY LIFE INSURANCE COMPANY | $20 | — | $20 | 1.49% |
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 | 154 | 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) | 154 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 151 | $390K |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 109 | $57K |
| Vision | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 151 | $390K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 0 | $21K |
| Short-term disability | UNION SECURITY INSURANCE COMPANY | 36 | $18K |
| Other(2 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 5 | $4K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 151 | — |
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.