| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 | 55 E JACKSON BLVD CHICAGO, IL 60604 | DELTA DENTAL OF MASSACHUSETTS | $5K | — | $5K | 2.50% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NEW ENGLAND, LLC | 299 BALLARDVALE ST. WILMINGTON, MA 01887 | DELTA DENTAL OF MASSACHUSETTS | $495 | — | $495 | 0.25% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST LTD. | 55 E JACKSON BLVD. 14TH FLOOR A CHICAGO, IL 60604 | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | $14K | $4K | $19K | 11.92% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 55 E JACKSON BLVD. 14TH FLOOR A CHICAGO, IL 60604 | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | $2K | $636 | $3K | 10.30% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 55 E JACKSON BLVD FL 14 CHICAGO, IL 60604 | METROPOLITAN LIFE INSURANCE COMPANY | $3K | $55 | $3K | 18.81% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 16253 COLLECTION CENTER DR 40 W MADISON 4TH FL CHICAGO, IL 60693 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $252 | $252 | 1.84% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 55 E JACKSON BLVD. FL 14 CHICAGO, IL 60604 | METROPOLITAN LIFE INSURANCE COMPANY | $2K | $55 | $2K | 18.80% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 16253 COLLECTION CENTER DR. 40 W MADISON 4TH FL CHICAGO, IL 60693 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $241 | $241 | 1.84% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST LTD. | 55 W. MONROE STREET SUITE 500 CHICAGO, IL 60603 | DELTA DENTAL OF NEW JERSEY, INC | $536 | — | $536 | 4.91% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 55 E JACKSON BLVD FL 14 CHICAGO, IL 60604 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $55 | $55 | — |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 55 E JACKSON BLVD FL 14 CHICAGO, IL 60604 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $55 | $55 | — |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| AETNA LIFE INSURANCE COMPANY EIN 06-6033492 NONE | Contract Administrator Service code 13 | — | $238K |
| RXBENEFITS, INC. EIN 63-1157085 NONE | Claims processing Service code 12 | — | $3K |
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 | 252 | 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) | 252 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental(2 contracts, 2 carriers) | DELTA DENTAL OF MASSACHUSETTS | 541 | $212K |
| Vision | VISION SERVICE PLAN | 211 | $34K |
| Life insurance | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | 318 | $156K |
| Long-term disability | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | 102 | $28K |
| Stop-loss / reinsurancereinsurance | HM LIFE INSURANCE | 260 | $496K |
| Other(5 contracts, 2 carriers) | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | 318 | $183K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 541 | — |
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."
No prospect flags tripped on this filing.