| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 | 2120 PEWAUKEE RD SUITE 202 WAUKESHA, WI 53188 | ANTHEM BLUE CROSS AND BLUE SHIELD | $39K | — | $39K | 5.00% |
| FNA INSURANCE SERVICES INC3 | 1000 WOODBURY ROAD STE 403 WOODBURY, NY 11797 | ANTHEM BLUE CROSS AND BLUE SHIELD | — | $11K | $11K | 1.41% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 55 E JACKSON BLVD CHICAGO, IL 60604 | METROPOLITAN LIFE INSURANCE COMPANY | $4K | $65 | $4K | 6.78% |
| FNA INSURANCE SERVICES INC3 | 401 BROADHOLLOW RD FL 3 STE 303 MELVILLE, NY 11747 | METROPOLITAN LIFE INSURANCE COMPANY | $2K | — | $2K | 3.16% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 16253 COLLECTION CENTER DR 40 W MADISON 4TH FL BANK OF AM CHICAGO, IL 60693 | METROPOLITAN LIFE INSURANCE COMPANY | — | $335 | $335 | 0.63% |
| DISABILITY RMS3 | P.O. BOX 9757 PORTLAND, ME 04104 | NEW YORK LIFE INSURANCE COMPANY | — | $3K | $3K | 16.00% |
| KEPECS, ABRAHAM3 | 2 SKILLMAN STREET SUITE 305 BROOKLYN, NY 11205 | NEW YORK LIFE INSURANCE COMPANY | $3K | — | $3K | 15.01% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON INSURANCE SERVICES LLC | PO BOX 6030 PASADENA, CA 91102 | UNITEDHEALTHCARE INSURANCE COMPANY | $169 | — | $169 | 2.02% |
| KEPECS, ABRAHAM3 | 2 SKILLMAN STREET SUITE 305 BROOKLYN, NY 11205 | NEW YORK LIFE INSURANCE COMPANY | $1K | — | $1K | 15.00% |
| DISABILITY RMS3 | P.O. BOX 9757 PORTLAND, ME 04104 | NEW YORK LIFE INSURANCE COMPANY | — | $853 | $853 | 10.40% |
| KEPECS, ABRAHAM3 | 2 SKILLMAN STREET SUITE 305 BROOKLYN, NY 11205 | NEW YORK LIFE INSURANCE COMPANY | $835 | — | $835 | 15.11% |
| DISABILITY RMS3 | P.O. BOX 9757 PORTLAND, ME 04104 | NEW YORK LIFE INSURANCE COMPANY | — | $829 | $829 | 15.00% |
| IMA, INC.3 Filed as: IMA INC | 3475 E FOOTHILL BLVD SUITE 100 PASADENA, CA 91102 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $472 | — | $472 | 10.00% |
| PACIFIC ADVISORS LLC3 | 200 SW MARKET STREET SUITE 1850 PORTLAND, OR 97201 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $2 | — | $2 | 0.04% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 55 E JACKSON BLVD CHICAGO, IL 60604 | METROPOLITAN LIFE INSURANCE COMPANY | $48 | $66 | $114 | 16.50% |
| FNA INSURANCE SERVICES INC3 | 401 BROADHOLLOW RD FL 3 STE 303 MELVILLE, NY 11747 | METROPOLITAN LIFE INSURANCE COMPANY | $19 | — | $19 | 2.75% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 16253 COLLECTION CENTER DR 40 W MADISON 4TH FL BANK OF AM CHICAGO, IL 60693 | METROPOLITAN LIFE INSURANCE COMPANY | — | $4 | $4 | 0.58% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 55 E JACKSON BLVD CHICAGO, IL 60604 | METROPOLITAN LIFE INSURANCE COMPANY | $44 | $66 | $110 | 16.22% |
| FNA INSURANCE SERVICES INC3 | 401 BROADHOLLOW RD FL 3 STE 303 MELVILLE, NY 11747 | METROPOLITAN LIFE INSURANCE COMPANY | $18 | — | $18 | 2.65% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 16253 COLLECTION CENTER DR 40 W MADISON 4TH FL BANK OF AM CHICAGO, IL 60693 | METROPOLITAN LIFE INSURANCE COMPANY | — | $4 | $4 | 0.59% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 55 E JACKSON BLVD CHICAGO, IL 60604 | METROPOLITAN LIFE INSURANCE COMPANY | $41 | $66 | $107 | 16.29% |
| FNA INSURANCE SERVICES INC3 | 401 BROADHOLLOW RD FL 3 STE 303 MELVILLE, NY 11747 | METROPOLITAN LIFE INSURANCE COMPANY | $16 | — | $16 | 2.44% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 16253 COLLECTION CENTER DR 40 W MADISON 4TH FL BANK OF AM CHICAGO, IL 60693 | METROPOLITAN LIFE INSURANCE COMPANY | — | $3 | $3 | 0.46% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | — | METROPOLITAN GENERAL INSURANCE COMPANY | $109 | $66 | $175 | 38.98% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF NEW YORK INC | PO BOX 745841 ATLANTA, GA 30374 | METROPOLITAN GENERAL INSURANCE COMPANY | — | $6 | $6 | 1.34% |
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 | 99 | 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) | 99 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 2 carriers) | ANTHEM BLUE CROSS AND BLUE SHIELD | 111 | $777K |
| Dental(3 contracts, 3 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 196 | $66K |
| Vision(2 contracts, 2 carriers) | UNITEDHEALTHCARE INSURANCE COMPANY | 196 | $13K |
| Life insurance(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 97 | $58K |
| Short-term disability(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 97 | $70K |
| Long-term disability | NEW YORK LIFE INSURANCE COMPANY | 97 | $8K |
| Other(5 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 13 | $55K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 196 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.