| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 9855 SCRANTON ROAD, SUITE 100 SAN DIEGO, CA 92121 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $20K | — | $20K | 2.88% |
| HEALTH SAVINGS ASSOCIATES INSURANCE3 Filed as: HEALTH SAVINGS ASSOC SVCS INC | 687 S COAST HWY 101, STE 310 ENCINITAS, CT 92024 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $14K | — | $14K | 2.12% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 9855 SCRANTON ROAD, SUITE 100 SAN DIEGO, CA 92121 | KAISER FOUNDATION HEALTH PLAN INC | $14K | — | $14K | 2.97% |
| HEALTH SAVINGS ASSOCIATES INSURANCE3 Filed as: HEALTH SAVINGS ASSOC SVCS INC | 2655 CAMINO DEL RIO N, #200 SAN DIEGO, CA 92108 | KAISER FOUNDATION HEALTH PLAN INC | $9K | — | $9K | 2.02% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 9855 SCRANTON ROAD, SUITE 100 SAN DIEGO, CA 92121 | PRINCIPAL LIFE INSURANCE COMPANY | $11K | $2K | $13K | 6.53% |
| HEALTH SAVINGS ASSOCIATES INSURANCE3 Filed as: HEALTH SAVINGS ASSOC SVCS INC | 687 S COAST HWY 101, STE 310 ENCINITAS, CA 92024 | PRINCIPAL LIFE INSURANCE COMPANY | $8K | — | $8K | 3.98% |
| GARRY LYNN JOHNSON3 | 3850 E BASELINE RD, STE 121 MEZA, AZ 85206 | PRINCIPAL LIFE INSURANCE COMPANY | — | $4K | $4K | 2.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 9855 SCRANTON ROAD, SUITE 100 SAN DIEGO, CA 92121 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $9K | $1K | $10K | 9.79% |
| HEALTH SAVINGS ASSOCIATES INSURANCE3 Filed as: HEALTH SAVINGS ASSOC SVCS INC | 687 S COAST HWY 101, STE 310 ENCINITAS, CA 92024 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $7K | — | $7K | 6.36% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 9855 SCRANTON ROAD, SUITE 100 SAN DIEGO, CA 92121 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | — | $3K | 8.96% |
| HEALTH SAVINGS ASSOCIATES INSURANCE3 Filed as: HEALTH SAVINGS ASSOC SVCS INC | 687 S COAST HWY 101, STE 310 ENCINITAS, CA 92024 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | — | $2K | 5.39% |
| VARIOUS - SEE ATTACHED3 Filed as: AFLAC - SEE ATTACHMENT | 1932 WYNNTON ROAD COLUMBUS, GA 31999 | AFLAC | $4K | $133 | $4K | 15.77% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 9855 SCRANTON ROAD, SUITE 100 SAN DIEGO, CA 92121 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | $176 | $1K | 9.85% |
| HEALTH SAVINGS ASSOCIATES INSURANCE3 Filed as: HEALTH SAVINGS ASSOC SVCS INC | 687 S COAST HWY 101, STE 310 ENCINITAS, CA 92024 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $960 | — | $960 | 6.31% |
| MARSH & MCLENNAN AGENCY LLC3 | LOCKBOX 740659 LOS ANGELES, CA 90074 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $53 | $10 | $63 | 18.00% |
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 | 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 |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 92 | $1.1M |
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 139 | $202K |
| Vision | PRINCIPAL LIFE INSURANCE COMPANY | 139 | $202K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 139 | $202K |
| Short-term disability(2 contracts, 2 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 139 | $305K |
| Long-term disability(3 contracts, 2 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 139 | $321K |
| Prescription drug(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 92 | $1.1M |
| Other(3 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 30 | $63K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 139 | — |
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.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.