| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 600 CORPORATE POINTE, STE 600 CULVER CITY, CA 90230 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $264K | $9K | $273K | 7.82% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 600 CORPORATE POINTE, SUITE 600 CULVER CITY, CA 90230 | KAISER FOUNDATION HEALTH PLAN INC | $49K | — | $49K | 2.96% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 600 CORPORATE POINTE, SUITE 600 CULVER CITY, CA 90230 | CIGNA HEALTHCARE OF CALIFORNIA | $16K | — | $16K | 5.08% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 600 CORPORATE POINTE, SUITE 600 CULVER CITY, CA 90230 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $28K | $5K | $33K | 12.03% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INSTERNATIONAL | 600 CORPORATE POINTE, SUITE 600 CULVER CITY, CA 90230 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $18K | $3K | $21K | 11.89% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 600 CORPORATE POINTE, SUITE 600 CULVER CITY, CA 90230 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $13K | $2K | $15K | 11.92% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 600 CORPORATE POINTE, SUITE 600 CULVER CITY, CA 90230 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | $259 | $2K | 11.77% |
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 | 586 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 27 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 613 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 894 | $5.5M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 894 | $3.5M |
| Vision | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 894 | $3.5M |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 601 | $273K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 598 | $127K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 328 | $179K |
| Prescription drug(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 894 | $3.8M |
| Other | LIFE INSURANCE COMPANY OF NORTH AMERICA | 599 | $15K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 894 | — |
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.