| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHEAST LIMITED | 1000 WOODBURY ROAD WOODBURY, NY 11797 | EMPIRE HEALTHCHOICE ASSURANCE, INC. | $28K | $4K | $31K | 1.56% |
| ASSOCIATED AGENCIES, INC3 Filed as: ASSOCIATED AGENCIES INC | 1701 GOLF RD,TOWER 3, 7TH FLR ROLLING MEADOWS, IL 60008 | EMPIRE HEALTHCHOICE ASSURANCE, INC. | $12K | $0 | $12K | 0.59% |
| PROFESSIONAL GROUP PLANS INC3 | 225 WIRELESS BLVD HAUPPAUGE, NY 11788 | EMPIRE HEALTHCHOICE ASSURANCE, INC. | $0 | $6K | $6K | 0.31% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | PO BOX 4047 CONCORD, CA 94524 | EMPIRE HEALTHCHOICE ASSURANCE, INC. | $0 | $242 | $242 | 0.01% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHEAST LIMITED | 100 SUNNYSIDE BOULEVARD WOODBURY, NY 11797 | AETNA LIFE INSURANCE COMPANY | $3K | $3K | $6K | 7.19% |
| ASSOCIATED AGENCIES, INC3 Filed as: ASSOCIATED AGENCIES INC | 1701 GOLF RD ROLLING MEADOWS, IL 60008 | AETNA LIFE INSURANCE COMPANY | $1K | $0 | $1K | 1.35% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHEAST LTD | 1393 VETERANS MEMORIAL HWY,STE 210N HAUPPAUGE, NY 11788 | MUTUAL OF OMAHA INSURANCE COMPANY | $2K | $2K | $4K | 13.80% |
| ASSOCIATED AGENCIES, INC3 Filed as: ASSOCIATED AGENCIES INC | 1701 GOLF RD STE 3-700 ROLLING MEADOWS, IL 60008 | MUTUAL OF OMAHA INSURANCE COMPANY | $1K | $0 | $1K | 4.66% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHEAST LIMITED | 1393 VETERANS MEMORIAL HWY,STE 210N HAUPPAUGE, NY 11788 | COMPANION LIFE INSURANCE COMPANY | $1K | $2K | $3K | 15.03% |
| ASSOCIATED AGENCIES, INC3 Filed as: ASSOCIATED AGENCIES INC | 1701 GOLF RD, STE 3-700 ROLLING MEADOWS, IL 60008 | COMPANION LIFE INSURANCE COMPANY | $742 | $0 | $742 | 3.65% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHEAST LIMITED | 1393 VETERANS MEMORIAL HWY STE 210N HAUPPAUGE, NY 11788 | COMPANION LIFE INSURANCE COMPANY | $1K | $1K | $3K | 13.53% |
| ASSOCIATED AGENCIES, INC3 Filed as: ASSOCIATED AGENCIES INC | 1701 GOLF RD STE 3-700 ROLLING MEADOWS, IL 60008 | COMPANION LIFE INSURANCE COMPANY | $732 | $0 | $732 | 3.91% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHEAST LTD | 1393 VETERANS MEMORIAL HWY,STE 210N HAUPPAUGE, NY 11788 | MUTUAL OF OMAHA INSURANCE COMPANY | $1K | $1K | $2K | 14.49% |
| ASSOCIATED AGENCIES, INC3 Filed as: ASSOCIATED AGENCIES INC | 1701 GOLF RD STE 3-700 ROLLING MEADOWS, IL 60008 | MUTUAL OF OMAHA INSURANCE COMPANY | $619 | $0 | $619 | 3.67% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHEAST LTD | 1393 VETERANS MEMORIAL HWY,STE 210N HAUPPAUGE, NY 11788 | MUTUAL OF OMAHA INSURANCE COMPANY | $220 | $268 | $488 | 13.54% |
| ASSOCIATED AGENCIES, INC3 Filed as: ASSOCIATED AGENCIES INC | 1701 GOLF RD STE 3-700 ROLLING MEADOWS, IL 60008 | MUTUAL OF OMAHA INSURANCE COMPANY | $141 | $0 | $141 | 3.91% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHEAST LTD | 1393 VETERANS MEMORIAL HWY,STE 210N HAUPPAUGE, NY 11788 | MUTUAL OF OMAHA INSURANCE COMPANY | $57 | $84 | $141 | 15.60% |
| ASSOCIATED AGENCIES, INC3 Filed as: ASSOCIATED AGENCIES INC | 1701 GOLF RD STE 3-700 ROLLING MEADOWS, IL 60008 | MUTUAL OF OMAHA INSURANCE COMPANY | $33 | $0 | $33 | 3.65% |
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 | 203 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 204 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | EMPIRE HEALTHCHOICE ASSURANCE, INC. | 165 | $2.0M |
| Dental | AETNA LIFE INSURANCE COMPANY | 194 | $90K |
| Vision | EMPIRE HEALTHCHOICE ASSURANCE, INC. | 165 | $2.0M |
| Life insurance(3 contracts, 2 carriers) | COMPANION LIFE INSURANCE COMPANY | 165 | $43K |
| Short-term disability | MUTUAL OF OMAHA INSURANCE COMPANY | 35 | $17K |
| Long-term disability | MUTUAL OF OMAHA INSURANCE COMPANY | 165 | $31K |
| Other(2 contracts) | MUTUAL OF OMAHA INSURANCE COMPANY | 165 | $5K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 194 | — |
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.