| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHEAST | 100 SUNNYSIDE BOULEVARD WOODBURY, NY 11797 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $7K | $105K | $112K | 3.25% |
| KISTLER TIFFANY BENEFITS3 | 899 CASSATT ROAD, SUITE 200 BERWYN, PA 19312 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $883 | $19K | $20K | 0.58% |
| PREMIER WORKSITE SOLUTIONS INC3 Filed as: PREMIER WORKSITE SOLUTIONS LLC | 700 KINDERKAMACK ROAD, SUITE 205 ORADELL, NJ 07675 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $11K | $84 | $11K | 8.46% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHEAST LTD | 100 SUNNYSIDE BOULEVARD WOODBURY, NY 11797 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $5K | $90 | $5K | 3.90% |
| EMERSON REID LLC3 Filed as: EMERSON REID, LLC | 1787 SENTRY PARKWAY WEST, VEVA 16 SUITE 320 BLUE BELL, PA 19422 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $2K | — | $2K | 1.19% |
| CUSTOM BENEFIT PROGRAMS INC3 | 897 12TH STREET HAMMONTON, NJ 08037 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $778 | — | $778 | 0.59% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST LTD | 55 E JACKSON BOULEVARD, #14A CHICAGO, IL 60604 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | — | $274 | $274 | 0.21% |
| TRAN, THANH, VAN3 | 5409 OLD STAGE ROAD RALEIGH, NC 27603 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $84 | — | $84 | 0.06% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHEAST | 100 SUNNYSIDE BOULEVARD WOODBURY, NY 11797 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $9K | $358 | $9K | 12.31% |
| KISTLER TIFFANY BENEFITS3 | 899 CASSATT ROAD, SUITE 200 BERWYN, PA 19312 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $245 | $2K | 3.10% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST LTD | 55 E JACKSON BOULEVARD #14A CHICAGO, IL 60604 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $90 | $90 | 0.12% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHEAST | 100 SUNNYSIDE BOULEVARD WOODBURY, NY 11797 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $7K | $280 | $7K | 12.63% |
| KISTLER TIFFANY BENEFITS3 | 899 CASSATT ROAD, SUITE 200 BERWYN, PA 19312 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $195 | $2K | 3.18% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INERNATIONAL MIDWEST LTD | 55 E JACKSON BOULEVARD, #14A CHICAGO, IL 60604 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $76 | $76 | 0.13% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHEAST LTD | 100 SUNNYSIDE BOULEVARD WOODBURY, NY 11797 | METROPOLITAN LIFE INSURANCE COMPANY | $4K | $54 | $4K | 9.01% |
| KISTLER TIFFANY BENEFITS3 Filed as: KISTLER TIFFANY BENEFITS CO | 899 CASSATT ROAD, SUITE 200 BERWYN, PA 19312 | METROPOLITAN LIFE INSURANCE COMPANY | $483 | — | $483 | 0.98% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHEAST LTD | 200 CROSSINGS BOULEVARD, SUITE 110 WARWICK, RI 02886 | METROPOLITAN LIFE INSURANCE COMPANY | — | $133 | $133 | 0.27% |
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 | 441 | 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) | 441 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 441 | $3.6M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 267 | $3.4M |
| Vision | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 267 | $3.4M |
| Life insurance(3 contracts, 3 carriers) | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 441 | $257K |
| Short-term disability | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 441 | $132K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 87 | $59K |
| Other(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 441 | $125K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 441 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.