| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 970 RESERVE DRIVE, SUITE 200 ROSEVILLE, CA 95678 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $4K | — | $4K | 5.00% |
| TEEMWURK, INC.3 Filed as: TEEMWURK INC | 5857 OWENS AVENUE, STE 300 CARLSBAD, CA 92008 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $1K | $1K | 2.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 970 RESERVE DRIVE, SUITE 200 ROSEVILLE, CA 95678 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $3K | $7K | 17.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 970 RESERVE DRIVE, SUITE 200 ROSEVILLE, CA 95678 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $2K | — | $2K | 5.00% |
| TEEMWURK, INC.3 Filed as: TEEMWURK INC | 5857 OWENS AVENUE, STE 300 CARLSBAD, CA 92008 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $864 | $864 | 2.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 970 RESERVE DRIVE, SUITE 200 ROSEVILLE, CA 95678 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $3K | $7K | 17.00% |
| VARIOUS - SEE ATTACHED3 Filed as: AFLAC - SEE ATTACHMENT | 1932 WYNNTON ROAD COLUMBUS, GA 31999 | AFLAC | $3K | — | $3K | 9.86% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 970 RESERVE DRIVE, SUITE 200 ROSEVILLE, CA 95678 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $2K | $4K | 17.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 970 RESERVE DRIVE, SUITE 200 ROSEVILLE, CA 95678 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $857 | $2K | 17.01% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 970 RESERVE DRIVE, SUITE 200 ROSEVILLE, CA 95678 | HUMANA INSURANCE COMPANY | $1K | — | $1K | 9.42% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 970 RESERVE DRIVE, SUITE 200 ROSEVILLE, CA 95678 | SUN LIFE ASSURANCE COMPANY OF CANADA | $545 | — | $545 | 10.07% |
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 | 147 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 149 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental(2 contracts) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 79 | $114K |
| Vision | HUMANA INSURANCE COMPANY | 107 | $12K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 147 | $56K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 147 | $39K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 147 | $22K |
| Other(4 contracts, 3 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 147 | $91K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 147 | — |
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.