| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: COOK MARAN AND ASSOCIATE,S INC. | 461 PANTIGO ROAD EAST HAMPTON, NY 11937 | EMPIRE HEALTHCHOICE ASSURANCE, INC. | $101K | $0 | $101K | 3.80% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: COOK MARAN AND ASSOCIATES INC. | 40 MARCUS DRIVE, 3RD FLOOR MELVILLE, NY 11747 | EMPIRE HEALTHCHOICE ASSURANCE, INC. | $7K | $0 | $7K | 0.28% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: COOK MARAN AND ASSOCIATES, INC. | 461 PANTIGO ROAD EAST HAMPTON, NY 11937 | MUTUAL OF OMAHA INSURANCE COMPANY | $13K | $73 | $13K | 14.65% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: COOK MARAN AND ASSOCIATES, INC. | 461 PANTIGO ROAD EAST HAMPTON, NY 11937 | COMPANION LIFE INSURANCE COMPANY | $4K | $0 | $4K | 10.00% |
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 | 313 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 315 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | EMPIRE HEALTHCHOICE ASSURANCE, INC. | 431 | $2.7M |
| Dental | EMPIRE HEALTHCHOICE ASSURANCE, INC. | 431 | $2.7M |
| Vision | EMPIRE HEALTHCHOICE ASSURANCE, INC. | 431 | $2.7M |
| Life insurance | COMPANION LIFE INSURANCE COMPANY | 313 | $36K |
| Short-term disability | MUTUAL OF OMAHA INSURANCE COMPANY | 313 | $90K |
| Long-term disability | MUTUAL OF OMAHA INSURANCE COMPANY | 313 | $90K |
| Prescription drug | EMPIRE HEALTHCHOICE ASSURANCE, INC. | 431 | $2.7M |
| Other | MUTUAL OF OMAHA INSURANCE COMPANY | 313 | $90K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 431 | — |
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.