| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NEW ENGLAND LLC | 300 BALLARDVALE STREET, PO BOX 696 WILMINGTON, MA 01887 | ANTHEM HEALTH PLANS OF MAINE, INC. | $30K | — | $30K | 2.67% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NEW ENGLAND LLC | 275 US ROUTE 1 CUMB FORESIDE, ME 04110 | AMERITAS LIFE INSURANCE CORP. | $3K | — | $3K | 3.96% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SERVICE | PO BOX 2158 RIVERSIDE, CA 925162158 | AMERITAS LIFE INSURANCE CORP. | — | $2K | $2K | 3.06% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NEW ENGLAND LLC | 96 SHAKER RD. E. LONGMEADOW, MA 01028 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $365 | $2K | 13.87% |
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 | 120 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 120 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | ANTHEM HEALTH PLANS OF MAINE, INC. | 221 | $1.1M |
| Dental | AMERITAS LIFE INSURANCE CORP. | 268 | $69K |
| Vision | AMERITAS LIFE INSURANCE CORP. | 268 | $69K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 153 | $15K |
| Other | UNUM LIFE INSURANCE COMPANY OF AMERICA | 153 | $15K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 268 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.