| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SERVICE | 1393 VETERANS MEMORIAL HWY WOODBURY, NY 11797 | UNITED HEALTHCARE INSURANCE COMPANY | $18K | — | $18K | 1.52% |
| LEANN O'HARA3 | 361 E MANHASSET STREET TERRACE, NY 11752 | UNITED HEALTHCARE INSURANCE COMPANY | $18K | — | $18K | 1.48% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SERVICE | 1393 VETERANS MEMORIAL HWY WOODBURY, NY 11797 | METROPOLITAN LIFE INSURANCE COMPANY | $2K | $958 | $3K | 4.75% |
| LEANN O'HARA3 | 361 E MANHASSET STREET TERRACE, NY 11752 | METROPOLITAN LIFE INSURANCE COMPANY | $756 | — | $756 | 1.20% |
| THE PAUL REVERE LIFE INSURANCE3 | P.O. BOX 1365 COLUMBIA, SC 29202 | THE PAUL REVERE LIFE INSURANCE COMPANY | $4K | $242 | $4K | 16.49% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SERVICE | 1393 VETERANS MEMORIAL HWY WOODBURY, NY 11797 | NEW YORK LIFE GROUP INSURANCE COMPANY OF NEW YORK | $1K | $225 | $1K | 11.52% |
| LEANN O'HARA3 | 361 E MANHASSET STREET TERRACE, NY 11752 | NEW YORK LIFE GROUP INSURANCE COMPANY OF NEW YORK | $1K | — | $1K | 7.77% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SERVICE | 100 SUNNYSIDE BLVD. WOODBURY, NY 11797 | AETNA LIFE INSURANCE COMPANY | $547 | — | $547 | 5.79% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SERVICE | 1393 VETERANS MEMORIAL HWY WOODBURY, NY 11797 | NEW YORK LIFE GROUP INSURANCE COMPANY OF NEW YORK | $605 | $137 | $742 | 9.64% |
| LEANN O'HARA3 | 361 E MANHASSET STREET TERRACE, NY 11752 | NEW YORK LIFE GROUP INSURANCE COMPANY OF NEW YORK | $475 | — | $475 | 6.17% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SERVICE | 1393 VETERANS MEMORIAL HWY WOODBURY, NY 11797 | NEW YORK LIFE GROUP INSURANCE COMPANY OF NEW YORK | $144 | $8 | $152 | 8.32% |
| LEANN O'HARA3 | 361 E MANHASSET STREET TERRACE, NY 11752 | NEW YORK LIFE GROUP INSURANCE COMPANY OF NEW YORK | $113 | — | $113 | 6.18% |
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 | 119 | 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) | 119 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITED HEALTHCARE INSURANCE COMPANY | 137 | $1.2M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 186 | $63K |
| Vision | AETNA LIFE INSURANCE COMPANY | 112 | $9K |
| Life insurance | NEW YORK LIFE GROUP INSURANCE COMPANY OF NEW YORK | 119 | $8K |
| Long-term disability | NEW YORK LIFE GROUP INSURANCE COMPANY OF NEW YORK | 119 | $13K |
| Other(2 contracts, 2 carriers) | THE PAUL REVERE LIFE INSURANCE COMPANY | 119 | $29K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 186 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.