| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHEAST LIMITED | 100 SUNNYSIDE BLVD WOODBURY, NY 11797 | UNITEDHEALTHCARE INSURANCE COMPANY | $13K | — | $13K | 3.63% |
| POPULAR RISK SERVICES, LLC3 Filed as: POPULAR INSURANCE AGENCY USA INC | PO BOX 362708 SAN JUAN, PR 009362708 | UNITEDHEALTHCARE INSURANCE COMPANY | $3K | — | $3K | 0.91% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL PUERTO RICO, INC | 255 PONCE DE LEON AVE MCS PLAZA STE 700 SAN JUAN, PR 00917 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $26K | — | $26K | 10.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL PUERTO RICO, INC | 255 PONCE DE LEON AVE MCS PLAZA STE 700 SAN JUAN, PR 00917 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $21K | — | $21K | 12.50% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL PUERTO RICO, INC | 255 PONCE DE LEON AVE MCS PLAZA STE 700 SAN JUAN, PR 00917 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $11K | — | $11K | 10.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NE | 1065 AVENUE OF THE AMERICAS NEW YORK, NY 100180831 | UNITEDHEALTHCARE INSURANCE COMPANY | $5K | — | $5K | 7.22% |
| POPULAR RISK SERVICES, LLC3 Filed as: POPULAR INSURANCE AGENCY USA INC | PO BOX 362708 SAN JUAN, PR 009362708 | UNITEDHEALTHCARE INSURANCE COMPANY | $1K | — | $1K | 1.81% |
| RHONA S UNSELL INC4 Filed as: RHONA S. UNSELL INC. | SUITE 370 152 6525 GUNPARK DRIVE BOULDER, CO 80301 | PRE PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $983 | — | $983 | 16.73% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UNITED HEALTHCARE SERVICES, INC. EIN 41-1289245 CLAIMS PROCESSOR | Claims processing; Other services Service code 12 | — | $520K |
| HUB INTERNATIONAL NORTHEAST LIMITED EIN 13-3621603 BROKER | Other commissions Service code 55 | — | $51K |
| POPULAR INSURANCE AGENCY USA INC. EIN 36-4473714 BROKER | Other commissions Service code 55 | — | $10K |
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 | 759 | 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) | 759 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | UNITEDHEALTHCARE INSURANCE COMPANY | 589 | $366K |
| Vision | UNITEDHEALTHCARE INSURANCE COMPANY | 475 | $65K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 743 | $264K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 744 | $166K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 744 | $107K |
| Prescription drug | MC-21 LLC (D/B/A MC-RX) | 446 | $0 |
| Other(3 contracts, 3 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 759 | $280K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 759 | — |
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.