| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS, INC. | PO BOX 2158 RIVERSIDE, CA 92516 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $4K | $0 | $4K | 0.14% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 1550 AVIATION PARKWAY, SUITE 300 MORRISVILLE, NC 27560 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $3K | $0 | $3K | 0.13% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS | 422 WAUPONSEE STREET MORRIS, IL 60450 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $6K | $6K | 2.46% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 55 EAST JACKSON BOULEVARD 14TH FLOOR, SUITE 14A CHICAGO, IL 60604 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $4K | $4K | 1.86% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 4819 EMPEROR BOULEVARD DURHAM, NC 27703 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | $0 | $1K | 0.60% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL OF CA INSURANCE | PO BOX 2158 RIVERSIDE, CA 92516 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | $0 | $1K | 0.51% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SERVICE | 10 HUDSON YARDS NEW YORK, NY 10001 | BERKSHIRE LIFE INSURANCE COMPANY | $61K | — | $61K | 35.54% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 1550 AVIATION PARKWAY, SUITE 300 MORRISVILLE, NC 27560 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $63 | $63 | 0.04% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS, INC | PO BOX 2158 RIVERSIDE, CA 92516 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $44 | $44 | 0.03% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 55 EAST JACKSON BOULEVARD CHICAGO, IL 60604 | LEGALEASE | $752 | — | $752 | 10.00% |
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 | 110 | 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) | 110 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 190 | $2.7M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 301 | $159K |
| Vision | VISION SERVICE PLAN | 119 | $21K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 110 | $236K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 110 | $236K |
| Long-term disability(2 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 110 | $408K |
| Prescription drug(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 190 | $2.7M |
| Other(3 contracts, 3 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 190 | $2.8M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 301 | — |
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.