| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | 299 BALLARDVALE STREET WILMINGTON, MA 01887 | HARTFORD LIFE AND ACCIDENT | $80K | $0 | $80K | 13.71% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | 55 EAST JACKSON SUITE 14B CHICAGO, IL 60604 | HARTFORD LIFE AND ACCIDENT | $0 | $11K | $11K | 1.86% |
| CUSTOM BENEFIT PROGRAMS INC3 Filed as: CUSTOM BENEFIT PROGRAMS | 897 12TH STREET HAMMONTON, NJ 08037 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $78K | $13K | $91K | 35.66% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | 299 BALLARDVALE STREET WILMINGTON, MA 01887 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $33K | $3K | $36K | 14.30% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | 299 BALLARDVALE STREET WILMINGTON, MA 01887 | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $5K | $0 | $5K | 4.18% |
| CUSTOM BENEFIT PROGRAMS INC3 Filed as: CUSTOM BENEFIT PROGRAMS | 897 12TH STREET HAMMONTON, NJ 08037 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $21K | $5K | $26K | 55.96% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | 299 BALLARDVALE STREET WILMINGTON, MA 01887 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $9K | $588 | $10K | 20.92% |
| CUSTOM BENEFIT PROGRAMS INC3 Filed as: CUSTOM BENEFIT PROGRAMS | 897 12TH STREET HAMMONTON, NJ 08037 | FIRST UNUM LIFE INSURANCE COMPANY | $1K | $0 | $1K | 24.75% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | 299 BALLARDVALE STREET WILMINGTON, MA 01887 | FIRST UNUM LIFE INSURANCE COMPANY | $540 | $0 | $540 | 10.62% |
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 | 1,075 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 16 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,094 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN OF HAWAII | 5 | $38K |
| Vision | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 629 | $124K |
| Life insurance(3 contracts, 3 carriers) | HARTFORD LIFE AND ACCIDENT | 1,444 | $638K |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 1,444 | $587K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 1,444 | $587K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN OF HAWAII | 5 | $38K |
| Other(2 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 1,444 | $841K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,444 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.