| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHEAST LIMITED | 401 BROADHOLLOW ROAD MELVILLE, NY 11747 | AETNA LIFE INSURANCE COMPANY | $0 | $6K | $6K | 0.22% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHEAST LIMITED | 100 SUNNYSIDE BOULEVARD WOODBURY, NY 11797 | DELTA DENTAL OF NEW JERSEY, INC. | $8K | $0 | $8K | 7.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATINAL NORTHEAST LIMITED | PO BOX 4144882 BOSTON, MA 02241 | HARTFORD LIFE AND ACCIDENT | $4K | $0 | $4K | 5.62% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 1591 GALBRAITH AVENUE SE GRAND RAPIDS, MI 49546 | HARTFORD LIFE AND ACCIDENT | $0 | $3K | $3K | 4.91% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHEAST LIMITED | UNKNOWN MELVILLE, NY 11747 | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | $6K | $2K | $8K | 16.96% |
| FNA INSURANCE SERVICES INC3 Filed as: FNA INS SERVICES | UNKNOWN MELVILLE, NY 11747 | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | $0 | $2K | $2K | 5.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHEAST LIMITED | 100 SUNNYSIDE BOULEVARD WOODBURY, NY 11797 | DELTA DENTAL OF CONNECTICUT, INC. | $2K | $0 | $2K | 7.01% |
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 | 425 | 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) | 425 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | AETNA LIFE INSURANCE COMPANY | 275 | $2.8M |
| Dental | DELTA DENTAL OF NEW JERSEY, INC. | 279 | $119K |
| Vision | DELTA DENTAL OF CONNECTICUT, INC. | 254 | $22K |
| Life insurance | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | 425 | $50K |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 436 | $68K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 436 | $68K |
| Prescription drug | AETNA LIFE INSURANCE COMPANY | 275 | $2.8M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 436 | — |
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.