| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SERVICE | 75 W TOWNE RIDGE PARKWAY T 2 S 400 SANDY, UT 84070 | REGENCE BLUECROSS BLUESHIELD OF UTAH | $25K | $3K | $28K | 3.74% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SERVICES | 75 W TOWNE RIDGE PARKWAY T 2 S 400 SANDY, UT 84070 | PRINCIPAL LIFE INSURANCE COMPANY | $2K | $0 | $2K | 6.89% |
| LEAVITT GROUP3 Filed as: BEEHIVE INSURANCE AGENCY | PO BOX 571431 SALT LAKE CITY, UT 84157 | PRINCIPAL LIFE INSURANCE COMPANY | $2K | $0 | $2K | 6.68% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL LIMITED | 150 N RIVERSIDE PLAZA #1700 CHICAGO, IL 60606 | PRINCIPAL LIFE INSURANCE COMPANY | $0 | $1K | $1K | 4.14% |
| LEAVITT GROUP3 Filed as: BEEHIVE INSURANCE AGENCY | 4393 S RIVERBOAT RD SUITE 200 TAYLORSVILLE, UT 84123 | AMERITAS LIFE INSURANCE CORP | $911 | $0 | $911 | 3.26% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SERVICE | 3390 UNIVERSITY AVE STE 300 RIVERSIDE, CA 92501 | AMERITAS LIFE INSURANCE CORP | $896 | $0 | $896 | 3.20% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HUB INTERNATIONAL INSURANCE ADMINISTRATOR | Contract Administrator Service code 13 | 3390 UNIVERSITY AVE SUITE 300 RIVERSIDE, CA 92501 | $31K |
| BEEHIVE INSURANCE SERVICES ADMINISTRATOR | Contract Administrator Service code 13 | PO BOX 571431 SALT LAKE CITY, UT 84070 | $3K |
| HUB INTERNATIONAL LIMITED ADMINISTRATOR | Contract Administrator Service code 13 | 150 N RIVERSDIE PLZ SUITE 1700 CHICAGO, IL 60606 | $1K |
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 | 119 | 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) | 119 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | REGENCE BLUECROSS BLUESHIELD OF UTAH | 110 | $742K |
| Dental | AMERITAS LIFE INSURANCE CORP | 100 | $28K |
| Vision | AMERITAS LIFE INSURANCE CORP | 100 | $28K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 119 | $30K |
| Short-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 119 | $30K |
| Long-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 119 | $30K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 119 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.