| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | 5 BRYANT PARK 4TH FLOOR NEW YORK, NY 10018 | CIGNA LIFE INSURANCE COMPANY OF NEW YORK | $32K | $7K | $39K | 15.81% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62939 VIRGINIA BEACH, VA 23466 | CIGNA LIFE INSURANCE COMPANY OF NEW YORK | $0 | $1K | $1K | 0.57% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHEAST LIMITED | 1065 AVENUE OF THE AMERICAS 4TH FLOOR NEW YORK, NY 10018 | FIRST UNUM LIFE INSURANCE COMPANY | $21K | $0 | $21K | 10.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHEAST LIMITED | 180 RIVER ROAD, 2ND FLOOR SUMMIT, NY 07901 | FIRST UNUM LIFE INSURANCE COMPANY | $0 | $3K | $3K | 1.25% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHEAST LIMITED | 1065 AVENUE OF THE AMERICAS 4TH FLOOR NEW YORK, NY 10018 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $19K | $0 | $19K | 10.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHEAST LIMITED | 180 RIVER ROAD, 2ND FLOOR SUMMIT, NY 07901 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $2K | $2K | 1.25% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHEAST LIMITED | 1000 WOODBURY ROAD WOODBURY, CA 11797 | ANTHEM INSURANCE COMPANIES, INC. | $22K | $0 | $22K | 11.88% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | PO BOX 4047 CONCORD, CA 94524 | ANTHEM INSURANCE COMPANIES, INC. | $0 | $4K | $4K | 2.23% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHEAST LIMITED | 100 SUNNYSIDE BOULEVARD WOODBURY, NY 11797 | METROPOLITAN PROPERTY AND CASUALTY INSURANCE COMPANY | $9K | $1K | $10K | 11.62% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHEAST LIMITED | 100 SUNNYSIDE BOULEVARD WOODBURY, NY 11797 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $1K | $0 | $1K | 2.96% |
| REUBEN WARNER ASSOCIATES, INC.3 | 1655 RICHMOND AVENUE STATEN ISLAND, NY 10314 | ACE AMERICAN INSURANCE COMPANY | $4K | $0 | $4K | 20.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 5 BRYANT PARK, 4TH FLOOR NEW YORK, NY 10018 | ACE AMERICAN INSURANCE COMPANY | $3K | $0 | $3K | 15.00% |
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 | 1,571 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 248 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 24 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,843 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN INC | 13 | $82K |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 47 | $34K |
| Vision | ANTHEM INSURANCE COMPANIES, INC. | 2,755 | $184K |
| Life insurance(2 contracts, 2 carriers) | FIRST UNUM LIFE INSURANCE COMPANY | 1,571 | $404K |
| Long-term disability | CIGNA LIFE INSURANCE COMPANY OF NEW YORK | 1,571 | $244K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC | 13 | $82K |
| Other(2 contracts, 2 carriers) | METROPOLITAN PROPERTY AND CASUALTY INSURANCE COMPANY | 1,571 | $109K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,755 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.