| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | 299 BALLARDVALE STREET WILMINGTON, MA 01887 | TUFTS ASSOCIATED HEALTH MAINTENANCE ORG., INC. | $29K | $11K | $40K | 4.21% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | 299 BALLARDVALE STREET WILMINTON, MA 01887 | DELTA DENTAL OF MASSACHUSETTS | $5K | — | $5K | 4.54% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | 299 BALLARDVALE STREET WILMINGTON, MA 01887 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $6K | $2K | $7K | 14.78% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | 299 BALLARDVALE STREET WILMINGTON, MA 01887 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $816 | $35 | $851 | 3.23% |
| CHARLES S HOURIHAN3 | 12 HILLINGTON DRIVE NORTH EASTON, MA 02356 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $666 | $4 | $670 | 2.54% |
| MICHAEL S OBERLANDER3 Filed as: MICHAEL OBERLANDER AND OTHER AGENTS | PO BOX 171 REHOBOTH, MA 02769 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $515 | $34 | $549 | 2.08% |
| MJ INSURANCE3 Filed as: TINA M AUBIN AND VARIOUS AGENTS | PO BOX 292 AUBURN, MA 01501 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $337 | $34 | $371 | 1.41% |
| CHRISTINE GORDON3 | 123 CARRINGTON LANE UXBRIDGE, MA 01569 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $340 | $2 | $342 | 1.30% |
| KRISTY COLGATE3 Filed as: KRISTY HOLGATE | 43 MAGILL DRIVE GRAFTONN, MA 01519 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $265 | — | $265 | 1.01% |
| JASON HARTMAN3 Filed as: JASON C SHAPIRO | 41 BRENTON STREET LITCHFIELD, NH 03052 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $227 | — | $227 | 0.86% |
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 | 100 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 13 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 113 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | TUFTS ASSOCIATED HEALTH MAINTENANCE ORG., INC. | 176 | $947K |
| Dental | DELTA DENTAL OF MASSACHUSETTS | 195 | $106K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 102 | $49K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 102 | $49K |
| Prescription drug | TUFTS ASSOCIATED HEALTH MAINTENANCE ORG., INC. | 176 | $947K |
| Other(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 102 | $75K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 195 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.