| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INERNATIONAL INS. SVCS., INC. | 100 SUNNYSIDE BOULEVARD WOODBURY, NY 11797 | UNITEDHEALTHCARE INSURANCE COMPANY | $13K | $0 | $13K | 2.75% |
| ALTOMARE FINANCIAL GROUP, INC.3 | 1680 ROUTE 23 NORTH WAYNE, NJ 07470 | HORIZON HEALTHCARE SERVICES, INC. | $5K | $0 | $5K | 3.74% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | 1393 VETERANS HIGHWAY, SUITE 210N HAUPPAUGE, NY 11788 | UNITEDHEALTHCARE INSURANCE COMPANY | $2K | $0 | $2K | 2.50% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INERNATIONAL INS. SVCS., INC. | 100 SUNNYSIDE BOULEVARD WOODBURY, NY 11797 | VISION SERVICE PLAN | $1K | $0 | $1K | 7.02% |
| MJ INSURANCE3 Filed as: SVETLANA ZEITLIN AND VARIOUS AGENTS | 105 ADDIS DRIVE CHURCHVILLE, PA 18966 | AFLAC | $212 | $0 | $212 | 8.40% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | AFLAC | $96 | $0 | $96 | 3.80% |
| SJC BUSINESS SERVICES LLC3 Filed as: SJC BUSINESS SERVICES, LLC | PO BOX 84 GREEN LANE, PA 18054 | AFLAC | $37 | $0 | $37 | 1.47% |
| EDWARD F MROWKA JR3 Filed as: EDWARD F. MROWKA JR. | 5106 TIMBER LANE SCHNECKSVILLE, PA 18078 | AFLAC | $32 | $0 | $32 | 1.27% |
| RUSSELL L. DAYVAULT3 | 2777 MEADOWVIEW COURT TARPON SPRINGS, FL 34688 | AFLAC | $29 | $0 | $29 | 1.15% |
| JACQUELINE M EBERZ3 Filed as: JACQUELINE M. EBERZ | 98 LAMP POST ROAD NEW BRITAIN, PA 18901 | AFLAC | $16 | $0 | $16 | 0.63% |
| SUZANNE DICIOCCIO3 | 933 WILLOW STREET BURLINGTON, NJ 08016 | AFLAC | $14 | $0 | $14 | 0.55% |
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 | 100 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 103 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITEDHEALTHCARE INSURANCE COMPANY | 220 | $479K |
| Dental | HORIZON HEALTHCARE SERVICES, INC. | 108 | $126K |
| Vision | VISION SERVICE PLAN | 86 | $15K |
| Life insurance | UNITEDHEALTHCARE INSURANCE COMPANY | 105 | $97K |
| Short-term disability | AFLAC | 3 | $3K |
| Long-term disability | UNITEDHEALTHCARE INSURANCE COMPANY | 105 | $97K |
| Prescription drug | UNITEDHEALTHCARE INSURANCE COMPANY | 220 | $479K |
| Other(3 contracts, 3 carriers) | UNITEDHEALTHCARE INSURANCE COMPANY | 122 | $101K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 220 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.