| 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 | AETNA LIFE INSURANCE COMPANY | $0 | $18K | $18K | 7.27% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHEAST LIMITED | 1393 VETERANS MEMORIAL HIGHWAY SUITE 210N HAUPPAUGE, NY 11788 | SUN LIFE ASSURANCE COMPANY OF CANADA | $7K | $2K | $9K | 10.58% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| AETNA LIFE INSURANCE COMPANY EIN 06-6033492 NONE | Contract Administrator Service code 13 | — | $154K |
| HUB INTERNATIONAL LIMITED NONE | Insurance agents and brokers; Insurance brokerage commissions and fees Service code 22 | 180 RIVER ROAD, 2ND FL SUMMIT, NJ 07901 | $18K |
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 | 263 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 5 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 1 | Vested but not currently using benefits. |
| Beneficiaries receiving benefits | 0 | Spouses or dependents with eligibility independent of the participant. |
| Total participants (= "Plan participants" tile) | 269 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | AETNA LIFE INSURANCE COMPANY | 269 | $606K |
| Dental | AETNA LIFE INSURANCE COMPANY | 677 | $251K |
| Vision | AETNA LIFE INSURANCE COMPANY | 677 | $251K |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 400 | $87K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 400 | $87K |
| Stop-loss / reinsurancereinsurance | AETNA LIFE INSURANCE COMPANY | 269 | $606K |
| Other | SUN LIFE ASSURANCE COMPANY OF CANADA | 400 | $87K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 677 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.