| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | UNKNOWN CAMBRIDGE, MA 02140 | BCBS OF MA | $26K | $10K | $36K | 3.61% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | 299 BALLARDVALE STREET WILMINGTON, MA 01887 | DELTA | $2K | $0 | $2K | 3.68% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | UNKNOWN WILMINGTON, MA 01887 | MONY LIFE INSURANCE COMPANY OF AMERICA | $5K | $0 | $5K | 12.16% |
| INDIGO INSURANCE SERVICES3 | UNKNOWN WORCESTER, MA 01608 | MONY LIFE INSURANCE COMPANY OF AMERICA | $0 | $3K | $3K | 5.69% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | 299 BALLARDVALE STREET SUITE 2 WILMINGTON, MA 01887 | EYEMED | $721 | $0 | $721 | 10.63% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | 299 BALLARDVALE STREET WILMINGTON, MA 01887 | AMERICAN GENERAL LIFE INSURANCE COMPANY | $498 | $0 | $498 | 14.99% |
| INDIGO INSURANCE SVC3 | 446 MAIN STREET 5TH FLOOR WORCESTER, MA 01608 | AMERICAN GENERAL LIFE INSURANCE COMPANY | $233 | $0 | $233 | 7.01% |
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 | 143 | 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) | 143 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BCBS OF MA | 164 | $993K |
| Dental | DELTA | 98 | $60K |
| Vision | EYEMED | 92 | $7K |
| Short-term disability(2 contracts, 2 carriers) | MONY LIFE INSURANCE COMPANY OF AMERICA | 161 | $48K |
| Long-term disability(2 contracts, 2 carriers) | MONY LIFE INSURANCE COMPANY OF AMERICA | 161 | $48K |
| Prescription drug | BCBS OF MA | 164 | $993K |
| Other(2 contracts, 2 carriers) | MONY LIFE INSURANCE COMPANY OF AMERICA | 161 | $48K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 164 | — |
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.