| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: COOK MARAN AND ASSOCIATES, INC. | 461 PANTIGO ROAD EAST HAMPTON, NY 11937 | OXFORD HEALTH INSURANCE, INC. | $139K | — | $139K | 3.63% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 377 OAK STREET, 5TH FLOOR GARDEN CITY, NY 11530 | OXFORD HEALTH INSURANCE, INC. | $12K | — | $12K | 0.32% |
| GALLAGHER BENEFIT SERVICES, INC.3 | TWO PIERCE PLACE, 14TH FLOOR ITASCA, IL 60143 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $36K | — | $36K | 3.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 | TWO PIERCE PLACE, 14TH FLOOR ITASCA, IL 60143 | VISION SERVICE PLAN | $678 | — | $678 | 3.74% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: COOK MARAN AND ASSOCIATES, INC. | 461 PANTIGO ROAD EAST HAMPTON, NY 11937 | VISION SERVICE PLAN | $371 | — | $371 | 2.05% |
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 | 304 | 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) | 304 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | OXFORD HEALTH INSURANCE, INC. | 714 | $5.1M |
| Vision | VISION SERVICE PLAN | 140 | $18K |
| Life insurance(2 contracts, 2 carriers) | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 304 | $0 |
| Prescription drug(2 contracts, 2 carriers) | OXFORD HEALTH INSURANCE, INC. | 714 | $5.1M |
| Other(2 contracts, 2 carriers) | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 304 | $0 |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 714 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.