| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | 299 BALLARDVALE STREET WILMINGTON, MA 01887 | MATTHEW THORNTON HEALTH PLAN, INC. | $87K | — | $87K | 2.50% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | 299 BALLARDVALE STREET WILMINGTON, MA 01887 | DELTA DENTAL PLAN OF NEW HAMPSHIRE, INC. | $8K | — | $8K | 3.26% |
| COMBINED SERVICES LLC3 Filed as: COMBINED SERVICES, LLC | PO BOX 1320 CONCORD, NH 03302 | DELTA DENTAL PLAN OF NEW HAMPSHIRE, INC. | $2K | — | $2K | 0.77% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | 299 BALLARDVALE STREET WILMINGTON, MA 01887 | SUN LIFE ASSURANCE COMPANY OF CANADA | $7K | — | $7K | 6.04% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | 600 LONGWATER DRIVE NORWELL, MA 02061 | VISION SERVICE PLAN | $532 | — | $532 | 9.43% |
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 | 420 | 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) | 423 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | MATTHEW THORNTON HEALTH PLAN, INC. | 561 | $3.5M |
| Dental | DELTA DENTAL PLAN OF NEW HAMPSHIRE, INC. | 557 | $231K |
| Vision | VISION SERVICE PLAN | 61 | $6K |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 420 | $121K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 420 | $121K |
| Prescription drug | MATTHEW THORNTON HEALTH PLAN, INC. | 561 | $3.5M |
| Other(2 contracts, 2 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 420 | $122K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 561 | — |
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.