| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | 4371 LATHAM STREET, SUITE 101 RIVERSIDE, CA 92501 | AETNA LIFE INSURANCE COMPANY | $309K | — | $309K | 4.19% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | 2029 CENTURY PARK EAST, SUITE 201 LOS ANGELES, CA 90067 | AETNA LIFE INSURANCE COMPANY | — | $67 | $67 | 0.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | 4371 LATHAM STREET, SUITE 101 RIVERSIDE, CA 92501 | AETNA HEALTH, INC. | $51K | $69K | $121K | 10.02% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | 4371 LATHAM STREET, SUITE 101 RIVERSIDE, CA 92501 | KAISER FOUNDATION HEALTH PLAN INC | $26K | — | $26K | 3.57% |
| PETER J MACE3 Filed as: PETER J. MACE | 5775 D GLENRIDGE DRIVE, SUITE 350 ATLANTA, GA 30328 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $48K | — | $48K | 7.96% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | PO BOX 2158 RIVERSIDE, CA 92516 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $21K | $2K | $23K | 3.78% |
| RICHARD M. KAGAN3 | 6701 CENTER DRIVE WEST, SUITE 1500 LOS ANGELES, CA 90045 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $22K | — | $22K | 3.66% |
| PETER J MACE3 Filed as: PETER J. MACE | 5775 D GLENRIDGE DRIVE NE SUITE 350 ATLANTA, GA 30328 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $46K | — | $46K | 52.67% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | PO BOX 2158 RIVERSIDE, CA 92516 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $20K | -$156 | $20K | 22.39% |
| HODGES-MACE BENEFITS GRP INC3 Filed as: HODGES-MACE BENEFITS GROUP INC. | 5775 D GLENRIDGE DRIVE NE SUITE 350 ATLANTA, GA 30328 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | — | -$916 | -$916 | -1.05% |
| PETER J MACE3 Filed as: PETER J. MACE | 5775 D GLENRIDGE DRIVE NE SUITE 350 ATLANTA, GA 30328 | FIRST UNUM LIFE INSURANCE COMPANY | $8K | — | $8K | 48.46% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | PO BOX 2158 RIVERSIDE, CA 92516 | FIRST UNUM LIFE INSURANCE COMPANY | $3K | — | $3K | 21.04% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | 6701 CENTER DRIVE WEST, SUITE 1500 LOS ANGELES, CA 90045 | EYEMED VISION CARE | $1K | — | $1K | 9.21% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | 4371 LATHAM STREET, SUITE 101 RIVERSIDE, CA 92501 | AMERICAN FIDELITY ASSURANCE COMPANY | $185 | — | $185 | 3.07% |
| PARAGON PARTNERS LTD3 | 9420 EAST DOUBLETREE RANCH ROAD SCOTTSDALE, AZ 85258 | AMERICAN FIDELITY ASSURANCE COMPANY | $89 | — | $89 | 1.48% |
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 | 1,344 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 8 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,352 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | AETNA LIFE INSURANCE COMPANY | 1,972 | $9.3M |
| Dental | AETNA LIFE INSURANCE COMPANY | 1,972 | $7.4M |
| Vision | EYEMED VISION CARE | 806 | $13K |
| Life insurance(3 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 839 | $710K |
| Short-term disability(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 839 | $612K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 839 | $606K |
| Prescription drug(3 contracts, 3 carriers) | AETNA LIFE INSURANCE COMPANY | 1,972 | $9.3M |
| Other(3 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 839 | $620K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,972 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.