| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHWEST LLC | PO BOX 749083 LOS ANGELES, CA 90074 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $0 | $21K | $21K | 2.91% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | 40 EAST ALAMAR AVENUE SANTA BARBARA, CA 93105 | AMERITAS LIFE INSURANCE CORPORATION | $0 | $3K | $3K | 5.44% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHWEST LLC | 6979 SE LAKE ROAD PORTLAND, OR 97267 | AMERITAS LIFE INSURANCE CORPORATION | $2K | $0 | $2K | 4.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHWEST LLC | 6979 SE LAKE ROAD PORTLAND, OR 97267 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $3K | $377 | $3K | 17.01% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHWEST LLC | 6979 SE LAKE ROAD PORTLAND, OR 97267 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $3K | $353 | $3K | 16.98% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHWEST LLC | 6979 SE LAKE ROAD PORTLAND, OR 97267 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $2K | $273 | $3K | 16.78% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHWEST LLC | PO BOX 749083 LOS ANGELES, CA 90074 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $1K | — | $1K | 14.15% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHWEST LLC | 12100 NORTHEAST 195TH STREET SUITE 200 BOTHELL, WA 98011 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $343 | — | $343 | 3.65% |
| TOLBERT BRIAN3 | 2817 WEST END AVENUE, SUITE 126-281 NASHVILLE, TN 37203 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $263 | $0 | $263 | 2.80% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC | PO BOX 2158 RIVERSIDE, CA 92516 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $0 | $53 | $53 | 0.56% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHWEST LLC | 6979 SE LAKE ROAD PORTLAND, OR 97267 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $977 | $152 | $1K | 14.35% |
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 | 117 | 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) | 117 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 137 | $736K |
| Dental | AMERITAS LIFE INSURANCE CORPORATION | 158 | $54K |
| Life insurance(2 contracts) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 117 | $26K |
| Short-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 34 | $19K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 34 | $15K |
| Prescription drug | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 137 | $736K |
| Other(3 contracts, 2 carriers) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 117 | $35K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 158 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
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.