| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ALLIANT INSURANCE SERVICES, INC.3 | 333 SOUTH HOPE STREET, SUITE 3750 LOS ANGELES, CA 90071 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | — | $8K | $8K | 4.45% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHEAST LTD | 401 BRAODHOLLOW RD MELVILLE, NY 11747 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | — | $2K | $2K | 1.32% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHEAST LTD | 1393 VETERANS MEMORIAL HWY STE 210N HAUPPAUGE, NY 11788 | MUTUAL OF OMAHA INSURANCE COMPANY | $967 | $979 | $2K | 8.05% |
| ALLIANT INSURANCE SERVICES, INC.3 | 333 SOUTH HOPE STREET, SUITE 3750 LOS ANGELES, CA 90071 | MUTUAL OF OMAHA INSURANCE COMPANY | $1K | — | $1K | 6.00% |
| FNA INSURANCE SERVICES INC3 | 1000 WOODBURY RD STE 403 WOODBURY, NY 11797 | MUTUAL OF OMAHA INSURANCE COMPANY | — | $483 | $483 | 2.00% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INS SERVICES INC | 333 SOUTH HOPE STREET, SUITE 3750 LOS ANGELES, CA 90071 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $1K | — | $1K | 7.29% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHEAST LTD | 401 BRAODHOLLOW ROAD MELVILLE, NY 11747 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | — | $317 | $317 | 1.85% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHEAST LTD | 1393 VETERANS MEMORIAL HWY STE 210N HAUPPAUGE, NY 11788 | COMPANION LIFE INSURANCE COMPANY | $575 | $524 | $1K | 11.75% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INS SERVICES INC | 333 SOUTH HOPE STREET, SUITE 3750 LOS ANGELES, CA 90071 | COMPANION LIFE INSURANCE COMPANY | $829 | — | $829 | 8.86% |
| FNA INSURANCE SERVICES INC3 | 1000 WOODBURY RD STE 403 WOODBURY, NY 11797 | COMPANION LIFE INSURANCE COMPANY | — | $192 | $192 | 2.05% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHEAST LTD | 1393 VETERANS MEMORIAL HWY STE 210N HAUPPAUGE, NY 11788 | MUTUAL OF OMAHA INSURANCE COMPANY | $467 | $314 | $781 | 9.93% |
| ALLIANT INSURANCE SERVICES, INC.3 | 333 SOUTH HOPE STREET, SUITE 3750 LOS ANGELES, CA 90071 | MUTUAL OF OMAHA INSURANCE COMPANY | $713 | — | $713 | 9.06% |
| FNA INSURANCE SERVICES INC3 | 1000 WOODBURY RD STE 403 WOODBURY, NY 11797 | MUTUAL OF OMAHA INSURANCE COMPANY | — | $156 | $156 | 1.98% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHEAST LTD | 1393 VETERANS MEMORIAL HWY STE 210N HAUPPAUGE, NY 11788 | COMPANION LIFE INSURANCE COMPANY | $110 | $112 | $222 | 8.20% |
| ALLIANT INSURANCE SERVICES, INC.3 | 333 SOUTH HOPE STREET, SUITE 3750 LOS ANGELES, CA 90071 | COMPANION LIFE INSURANCE COMPANY | $160 | — | $160 | 5.91% |
| FNA INSURANCE SERVICES INC3 | 1000 WOODBURY RD STE 403 WOODBURY, NY 11797 | COMPANION LIFE INSURANCE COMPANY | — | $55 | $55 | 2.03% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHEAST LTD | 1393 VETERANS MEMORIAL HWY STE 210N HAUPPAUGE, NY 11788 | MUTUAL OF OMAHA INSURANCE COMPANY | $63 | $64 | $127 | 8.21% |
| ALLIANT INSURANCE SERVICES, INC.3 | 333 SOUTH HOPE STREET, SUITE 3750 LOS ANGELES, CA 90071 | MUTUAL OF OMAHA INSURANCE COMPANY | $92 | — | $92 | 5.95% |
| FNA INSURANCE SERVICES INC3 | 1000 WOODBURY RD STE 403 WOODBURY, NY 11797 | MUTUAL OF OMAHA INSURANCE COMPANY | — | $32 | $32 | 2.07% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHEAST LTD | 1393 VETERANS MEMORIAL HWY STE 210N HAUPPAUGE, NY 11788 | MUTUAL OF OMAHA INSURANCE COMPANY | $71 | $64 | $135 | 12.41% |
| ALLIANT INSURANCE SERVICES, INC.3 | 333 SOUTH HOPE STREET, SUITE 3750 LOS ANGELES, CA 90071 | MUTUAL OF OMAHA INSURANCE COMPANY | $92 | — | $92 | 8.46% |
| FNA INSURANCE SERVICES INC3 | 1000 WOODBURY RD STE 403 WOODBURY, NY 11797 | MUTUAL OF OMAHA INSURANCE COMPANY | — | $24 | $24 | 2.21% |
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 | 127 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 6 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 133 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 117 | $174K |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 103 | $17K |
| Vision | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 103 | $17K |
| Life insurance(3 contracts, 2 carriers) | COMPANION LIFE INSURANCE COMPANY | 127 | $14K |
| Short-term disability | MUTUAL OF OMAHA INSURANCE COMPANY | 127 | $24K |
| Long-term disability | MUTUAL OF OMAHA INSURANCE COMPANY | 127 | $8K |
| Prescription drug | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 117 | $174K |
| Other(2 contracts) | MUTUAL OF OMAHA INSURANCE COMPANY | 127 | $3K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 127 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.