| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL N E LLC | UNKNOWN SOUTH DEERFIELD, MA 01373 | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | $43K | $11K | $53K | 3.32% |
| 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 | $3K | $9K | 15.17% |
| LORI A. FANEUF MCCASSIE3 | 12 BALLARD STREET OXFORD, MA 01540 | AFLAC | $3K | $150 | $3K | 10.86% |
| CHRISTOPHER E ROTH3 Filed as: CHRISTOPHER E. ROTH | 482 SOUTHBRIDGE STREET, SUITE 209 AUBURN, MA 01501 | AFLAC | $913 | $35 | $948 | 3.00% |
| SHAW ASSOCIATES INC3 Filed as: SHAW ASSOCIATES, INC. | 11 JOY LANE READING, MA 01867 | AFLAC | $403 | $23 | $426 | 1.35% |
| WILLIAM THOMAS FARRELL3 | 36 MILLBROOK DRIVE EAST LONGMEADOW, MA 01028 | AFLAC | $401 | $19 | $420 | 1.33% |
| MJ INSURANCE3 Filed as: KEVIN A. DELANEY AND VARIOUS AGENTS | 2 SWAN TERRACE GREENLAND, NH 03840 | AFLAC | $373 | $0 | $373 | 1.18% |
| BENEDIKT N MASON3 Filed as: BENEDIKT N. MASON | 17 LITTLE BEAR HILL ROAD WESTFORD, MA 01886 | AFLAC | $132 | $12 | $144 | 0.46% |
| THOMAS M MCGREEVY3 Filed as: THOMAS M. MCGREEVY | 763 GRIFFON AVENUE LAKE ALFRED, FL 33850 | AFLAC | $116 | $0 | $116 | 0.37% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NEW ENGLAND, LLC | 300 BALLARDVALE STREET WILMINGTON, MA 01887 | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | $470 | $0 | $470 | 9.00% |
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) | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 251 | $1.6M |
| Dental | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 251 | $1.6M |
| Vision | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | 151 | $5K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 143 | $58K |
| Short-term disability(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 143 | $90K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 251 | $1.6M |
| Other(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 143 | $90K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 251 | — |
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.