| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | 100 SUNNYSIDE BOULEVARD WOODBURY, NY 11797 | AETNA LIFE INSURANCE COMPANY AND AFFILIATES | $125K | $39K | $164K | 4.45% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | 100 SUNNYSIDE BOULEVARD WOODBURY, NY 11797 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $4K | $0 | $4K | 3.29% |
| PREMIER WORKSITE SOLUTIONS INC3 Filed as: PREMIER WORKSITE SOLUTIONS, LLC | 700 KINDERKAMACK ROAD, SUITE 205 ORADELL, NJ 07675 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $3K | $0 | $3K | 2.14% |
| EMERSON REID LLC3 Filed as: EMERSON REID, LLC | 1787 SENTRY PKWY, SUITE 320 BLUE BELL, PA 19422 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $0 | $2K | 1.51% |
| CUSTOM BENEFIT PROGRAMS INC3 Filed as: CUSTOM BENEFIT PROGRAMS | 897 12TH STREET HAMMONTON, NJ 08037 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $926 | $375 | $1K | 1.03% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | 55 EAST JACKSON BOULEVARD SUITE 14A CHICAGO, IL 60604 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $0 | $315 | $315 | 0.25% |
| TRAN, THANH, VAN3 | 1310 PROVIDENCE ROAD TOWSON, MD 21286 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $133 | $0 | $133 | 0.11% |
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 | 568 | 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) | 568 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | AETNA LIFE INSURANCE COMPANY AND AFFILIATES | 568 | $3.7M |
| Dental | AETNA LIFE INSURANCE COMPANY AND AFFILIATES | 568 | $3.7M |
| Vision | AETNA LIFE INSURANCE COMPANY AND AFFILIATES | 568 | $3.7M |
| Life insurance | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 440 | $126K |
| Short-term disability | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 440 | $126K |
| Prescription drug | AETNA LIFE INSURANCE COMPANY AND AFFILIATES | 568 | $3.7M |
| Other | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 440 | $126K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 568 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.