| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL PUERTO RICO, INC. | MCS PLAZA SUITE 700 255 PONCE DE LEON AVE. SAN JUAN, PR 00917 | METROPOLITAN LIFE INSURANCE COMPANY | $134K | — | $134K | 8.76% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL PUERTO RICO, INC. | MCS PLAZA SUITE 700 255 PONCE DE LEON AVE SAN JUAN, PR 00917 | TRIPLE-S VIDA, INC. | $19K | — | $19K | 7.79% |
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 | 2,309 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3,537 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 5,846 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(6 contracts, 2 carriers) | TRIPLE S SALUD | 3,048 | $9.3M |
| Dental(6 contracts, 2 carriers) | TRIPLE S SALUD | 3,048 | $9.3M |
| Vision(2 contracts, 2 carriers) | TRIPLE-S, INC. | 3,048 | $1.3M |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 4,752 | $1.5M |
| Long-term disability | TRIPLE-S VIDA, INC. | 1,662 | $249K |
| Prescription drug(6 contracts, 2 carriers) | TRIPLE S SALUD | 3,048 | $9.3M |
| Other | METROPOLITAN LIFE INSURANCE COMPANY | 4,752 | $1.5M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 4,752 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.