| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NEW ENGLAND LLC | 299 BALLARDVALE STREET WILMINGTON, MA 01887 | HARVARD PILGRIM HEALTH CARE | $21K | $0 | $21K | 2.96% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NEW ENGLAND LLC | 299 BALLARDVALE STREET WILMINGTON, MA 01887 | HARVARD PILGRIM HEALTH CARE | $3K | $0 | $3K | 2.99% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NE LLC | UNKNOWN BEVERLY, MA 01915 | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | $7K | $0 | $7K | 9.94% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NEW ENGLAND LLC | 1517 WILLOW LOOP PARK CITY, UT 84098 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $6K | $0 | $6K | 10.76% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NEW ENGLAND LLC | 300 BALLARDVALE STREET WILMINGTON, MA 01887 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $4K | $4K | 6.85% |
| REUBEN WARNER ASSOCIATES, INC.3 Filed as: REUBEN WARNER ASSOCIATES INC | 1655 RICHMOND AVENUE STATEN ISLAND, NY 10314 | HARTFORD LIFE AND ACCIDENT | $0 | $178 | $178 | 23.73% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | LOBBY 2 300 BALLARDVALE STREET WILMINGTON, MA 01887 | HARTFORD LIFE AND ACCIDENT | $113 | $0 | $113 | 15.07% |
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 | 122 | 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) | 122 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts) | HARVARD PILGRIM HEALTH CARE | 116 | $811K |
| Dental | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 144 | $74K |
| Vision | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 144 | $74K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 122 | $52K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 122 | $52K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 122 | $52K |
| Prescription drug(2 contracts) | HARVARD PILGRIM HEALTH CARE | 116 | $811K |
| Other(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 122 | $53K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 144 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.