| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARSH & MCLENNAN AGENCY LLC3 | PARK 80 WEST PLAZA 2 SADDLE BROOK, NJ 07663 | AETNA LIFE INSURANCE CO. | $8K | — | $8K | 0.61% |
| MARSH & MCLENNAN AGENCY LLC3 | 161 WASHINGTON STREET STE 1200 CONSHOHOCKEN, PA 19428 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | $302 | $2K | 11.50% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 55 E JACKSON BLVD 14TH FLOOR STE 14A CHICAGO, IL 60604 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $403 | $403 | 2.01% |
| MARSH & MCLENNAN AGENCY LLC3 | 161 WASHINGTON STREET STE 1200 CONSHOHOCKEN, PA 19428 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | $235 | $2K | 11.35% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 55 E JACKSON BLVD 14TH FLOOR STE 14A CHICAGO, IL 60604 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $313 | $313 | 1.80% |
| MARSH & MCLENNAN AGENCY LLC3 | 161 WASHINGTON STREET STE 1200 CONSHOHOCKEN, PA 19428 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | $229 | $2K | 11.48% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 55 E JACKSON BLVD 14TH FLOOR STE 14A CHICAGO, IL 60604 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $305 | $305 | 1.98% |
| MARSH & MCLENNAN AGENCY LLC3 | 1000 CORPORATE DRIVE FORT LAUDERDALE, FL 33334 | TRANSAMERICA LIFE INSURANCE COMPANY | $1K | — | $1K | 8.77% |
| DSM FINANCIAL LLC3 | 950 PENINSULA CORPORATE CIRCLE BOCA RATON, FL 33487 | TRANSAMERICA LIFE INSURANCE COMPANY | $454 | — | $454 | 3.70% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 3510 N CAUSEWAY BLVD STE 300 METAIRIE, LA 70002 | TRANSAMERICA LIFE INSURANCE COMPANY | $40 | — | $40 | 0.33% |
| EXCELSIOR BENEFITS LLC3 | 441 2ND STREET EXCELSIOR, MN 55331 | TRANSAMERICA LIFE INSURANCE COMPANY | $26 | — | $26 | 0.21% |
| MARSH & MCLENNAN AGENCY LLC3 | 161 WASHINGTON STREET STE 1200 CONSHOHOCKEN, PA 19428 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $869 | $135 | $1K | 11.55% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 55 E JACKSON BLVD 14TH FLOOR STE 14A CHICAGO, IL 60604 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $180 | $180 | 2.07% |
| MARSH & MCLENNAN AGENCY LLC3 | 161 WASHINGTON STREET STE 1200 CONSHOHOCKEN, PA 19428 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $90 | $22 | $112 | 12.46% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 55 E JACKSON BLVD 14TH FLOOR STE 14A CHICAGO, IL 60604 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $29 | $29 | 3.23% |
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 | 188 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 188 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | AETNA LIFE INSURANCE CO. | 188 | $1.4M |
| Dental | AETNA LIFE INSURANCE CO. | 188 | $1.4M |
| Vision | AETNA LIFE INSURANCE CO. | 188 | $1.4M |
| Life insurance(2 contracts) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 188 | $29K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 188 | $17K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 188 | $15K |
| Other(2 contracts) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 188 | $21K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 188 | — |
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.