| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHEAST LIMITED | 100 SUNNYSIDE BLVD WOODBURY, NY 11797 | UNITEDHEALTHCARE INSURANCE COMPANY | $52K | — | $52K | 3.67% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHEAST LIMITED | 1393 VETERANS MEMORIAL HWY HAUPPAUGE, NY 11788 | PRUDENTIAL | $8K | — | $8K | 5.83% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NEW ENGLAND LLC | 100 CENTRAL STREET HOLLISTON, MA 01746 | PRUDENTIAL | $2K | — | $2K | 1.82% |
| IMG5 | 2960 NORTH MERIDIAN STREET INDIANAPOLIS, IN 46208 | PRUDENTIAL | — | $26 | $26 | 0.02% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 1411 OPUS PL STE 450 DOWNERS GROVE, IL 60515 | UNITEDHEALTHCARE INSURANCE COMPANY | — | $3K | $3K | 3.14% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHEAST | 100 SUNNYSIDE BLVD WOODBURY, NY 11797 | UNITEDHEALTHCARE INSURANCE COMPANY | $1K | — | $1K | 1.36% |
| PPI BENEFIT SOLUTIONS5 | 10 RESEARCH PKWY WALLINGFORD, CT 06492 | EYE MED VISION CARE | — | $318 | $318 | 4.96% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 1393 VETERAN MEMORIAL HIGHWAY HAUPPAUGE, NY 11788 | EYE MED VISION CARE | $255 | — | $255 | 3.98% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| COMPSYCH EIN 35-3739763 THIRD PARTY ADMIN FEE | Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $0 |
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 | 139 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 143 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITEDHEALTHCARE INSURANCE COMPANY | 91 | $1.4M |
| Dental | UNITEDHEALTHCARE INSURANCE COMPANY | 92 | $85K |
| Vision | EYE MED VISION CARE | 77 | $6K |
| Life insurance | PRUDENTIAL | 139 | $129K |
| Short-term disability | PRUDENTIAL | 139 | $129K |
| Long-term disability | PRUDENTIAL | 139 | $129K |
| Prescription drug | UNITEDHEALTHCARE INSURANCE COMPANY | 91 | $1.4M |
| Other | PRUDENTIAL | 139 | $129K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 139 | — |
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.