| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NEW ENGLAND LLC | 299 BALLARDVALE STREET WILMINGTON, MA 01887 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $101K | $16K | $117K | 11.97% |
| CUSTOM BENEFIT PROGRAMS INC3 Filed as: CUSTOM BENEFIT PROGRAMS, INC. | 897 12TH STREET HAMMONTON, NJ 08037 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | $0 | $3K | 0.34% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NEW ENGLAND LLC | 1667 ELM STREET, SUITE 3 MANCHESTER, NH 03101 | EYEMED VISION CARE ON BEHALF OF FIDELEITY SECURITY LIFE INSURANCE CO. | $12K | $0 | $12K | 11.45% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NEW ENGLAND LLC | 299 BALLARDVALE STREET WILMINGTON, MA 01887 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $4K | $239 | $5K | 7.29% |
| CUSTOM BENEFIT PROGRAMS INC3 Filed as: CUSTOM BENEFIT PROGRAMS, INC. | 897 12TH STREET HAMMONTON, NJ 08037 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $897 | $384 | $1K | 2.03% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NEW ENGLAND LLC | 300 BALLARDVALE STREET WILMINGTON, MA 01887 | KAISER FOUNDATION HEALTH PLAN OF HAWAII | $2K | $0 | $2K | 3.77% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NEW ENGLAND LLC | 299 BALLARDVALE STREET WILMINGTON, MA 01887 | FIRST UNUM LIFE INSURANCE COMPANY | $108 | $0 | $108 | 3.20% |
| CUSTOM BENEFIT PROGRAMS INC3 Filed as: CUSTOM BENEFIT PROGRAMS, INC. | 897 12TH STREET HAMMONTON, NJ 08037 | FIRST UNUM LIFE INSURANCE COMPANY | $65 | $0 | $65 | 1.92% |
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 | 1,081 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 13 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | 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 | 7 | $57K |
| Vision | EYEMED VISION CARE ON BEHALF OF FIDELEITY SECURITY LIFE INSURANCE CO. | 1,203 | $104K |
| Life insurance(3 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,536 | $1.0M |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,536 | $974K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,536 | $974K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN OF HAWAII | 7 | $57K |
| Other | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,536 | $974K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,536 | — |
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.