| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| D. R. LARRIVEE3 Filed as: R.D. LARRIVEE | 1667 ELM STREET MANCHESTER, NH 03104 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $11K | $0 | $11K | 4.21% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | 299 BALLARDVALE STREET WILMINGTON, MA 01887 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $136 | $2K | 0.81% |
| WORK PLACE BENEFIT SOLUTIONS LLC3 | 1667 ELM STREET MANCHESTER, NH 03104 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $133 | $0 | $133 | 0.05% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF DELEWARE INC | PO BOX 2287 WILMINGTON, DE 19899 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $115 | $0 | $115 | 0.04% |
| EMPLOYEE FAMILY PROTECTION INC3 | PO BOX 1237 GLASTONBURY, CT 06033 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $40 | $0 | $40 | 0.02% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | PO BOX 61007 VIRGINIA BEACH, VA 23466 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2 | $0 | $2 | 0.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC | 299 BALLARDVALE STREET WILMINGTON, MA 01887 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $12K | $1K | $14K | 15.55% |
| WORKPLACE BENEFIT SOLUTIONS LLC3 | 1667 ELM STREET MANCHESTER, NH 03104 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $516 | $0 | $516 | 0.59% |
| EMPLOYEE FAMILY PROTECTION INC3 | PO BOX 1237 GLASTONBURY, CT 06033 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $499 | $0 | $499 | 0.57% |
| DAVID R. LARRIVEE3 Filed as: R DAVID LARRIVEE | 1667 ELM STREET MANCHESTER, NH 03104 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $333 | $0 | $333 | 0.38% |
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 | 465 | 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) | 465 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 479 | $343K |
| Short-term disability | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 224 | $87K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 479 | $256K |
| Other(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 479 | $343K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 479 | — |
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.