| 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 92506 | HEALTH NET | $14K | — | $14K | 5.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 4695 MACARTHUR COURT, SUITE 600 NEWPORT BEACH, CA 92660 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $1K | — | $1K | 10.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 3510 N CAUSEWAY BLVD SUITE 200 METAIRIE, LA 70002 | RELIANCE STANDARD LIFE INSURANCE COMPANY | — | $598 | $598 | 5.27% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 3390 UNIVERSITY AVE., SUITE 300 RIVERSIDE, CA 92501 | SUN LIFE ASSURANCE COMPANY OF CANADA | $836 | — | $836 | 7.76% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | PO BOX 4047 CONCORD, CA 94524 | SUN LIFE ASSURANCE COMPANY OF CANADA | $242 | — | $242 | 2.25% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 5600 NEW KING DR STE 210 TROY, MI 48098 | SUN LIFE ASSURANCE COMPANY OF CANADA | — | $192 | $192 | 1.78% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 4695 MACARTHUR COURT, SUITE 600 NEWPORT BEACH, CA 92660 | EYEMED VISION CARE ON BEHALF OF THE FIDELITY SECURITY LIFE INS COMPANY | $231 | — | $231 | 12.28% |
| FLEXVISION - MD3 | 15400 CALHOUN DR. STE. 125 ROCKVILLE, MD 20855 | EYEMED VISION CARE ON BEHALF OF THE FIDELITY SECURITY LIFE INS COMPANY | $116 | — | $116 | 6.17% |
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 | 111 | 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) | 111 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HEALTH NET | 12 | $270K |
| Dental | SUN LIFE ASSURANCE COMPANY OF CANADA | 9 | $11K |
| Vision | EYEMED VISION CARE ON BEHALF OF THE FIDELITY SECURITY LIFE INS COMPANY | 15 | $2K |
| Life insurance | RELIANCE STANDARD LIFE INSURANCE COMPANY | 75 | $11K |
| Other | RELIANCE STANDARD LIFE INSURANCE COMPANY | 75 | $11K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 75 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.