| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 1525 FARADAY AVENUE, SUITE 200 CARLSBAD, CA 92008 | AETNA LIFE INSURANCE COMPANY | $66K | $3K | $69K | 5.18% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 1525 FARADAY AVENUE, SUITE 200 CARLSBAD, CA 92008 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $22K | $5K | $27K | 12.91% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE INC | 400 GALLERIA PKWY, SUITE 300 ATLANTA, GA 30339 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | — | -$3 | -$3 | -0.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 1525 FARADAY AVENUE, SUITE 200 CARLSBAD, CA 82008 | AETNA HEALTH OF CALIFORNIA INC. | $7K | — | $7K | 5.09% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 1525 FARADAY AVENUE, SUITE 200 CARLSBAD, CA 92008 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4K | — | $4K | 15.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 1525 FARADAY AVENUE, SUITE 200 CARLSBAD, CA 92008 | ANTHEM LIFE INSURANCE COMPANY | $3K | $687 | $4K | 12.91% |
| ASSUREDPARTNERS3 Filed as: ASSUREDPARTNERS OF CA INS SVCS, LLC | 196 S FIR STREET VENTURA, CA 93002 | HARTFORD LIFE AND ACCIDENT | $122 | — | $122 | 15.02% |
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 | 128 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 131 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | AETNA LIFE INSURANCE COMPANY | 170 | $1.5M |
| Dental | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 263 | $211K |
| Vision | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 263 | $211K |
| Life insurance | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 263 | $211K |
| Long-term disability | ANTHEM LIFE INSURANCE COMPANY | 124 | $28K |
| Prescription drug(2 contracts, 2 carriers) | AETNA LIFE INSURANCE COMPANY | 170 | $1.5M |
| Other(3 contracts, 3 carriers) | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 263 | $240K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 263 | — |
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.