| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BENEFIT COMMERCE GROUP, LLC | 14300 N NORTHSIGHT BLVD SUITE 221 SCOTTSDALE, AZ 85260 | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | $7K | — | $7K | 9.88% |
| AXA ASSISTANCE, USA5 | 122 SOUTH MICHIGAN AVENUE SUITE 1100 CHICAGO, IL 606036115 | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $33 | $33 | 0.05% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BENEFIT COMMERCE GROUP | 14300 N NORTHSIGHT BLVD SCOTTSDALE, AZ 85260 | AVESIS INSURANCE INCORPORATED | $769 | — | $769 | 10.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH & LIFE INSURANCE GROUP EIN 59-1031071 NONE | Float revenue; Other services; Claims processing; Non-monetary compensation; Direct payment from the plan; Participant communication; Named fiduciary; Contract Administrator Service code 12 | — | $33K |
| ANGELONE & ASSOCIATES, INC. NONE | Insurance brokerage commissions and fees Service code 53 | 14300 N NORTHSIGHT BLVD, SUITE 221 SCOTTSDALE, AZ 85260 | $13K |
| BENEFIT COMMERCE GROUP, LLC NONE | Insurance brokerage commissions and fees Service code 53 | 14300 N NORTHSIGHT BLVD SUITE 221 SCOTTSDALE, AZ 85260 | $10K |
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 | 97 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 3 | Vested but not currently using benefits. |
| Beneficiaries receiving benefits | 0 | Spouses or dependents with eligibility independent of the participant. |
| Total participants (= "Plan participants" tile) | 101 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | AVESIS INSURANCE INCORPORATED | 104 | $8K |
| Life insurance | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | 120 | $73K |
| Short-term disability | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | 120 | $73K |
| Long-term disability | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | 120 | $73K |
| Other | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | 120 | $73K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 120 | — |
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.