| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NEW ENGLAND LLC | 299 BALLARDVALE STREET WILMINGTON, MA 01887 | HARVARD PILGRIM HEALTHCARE | $43K | $0 | $43K | 3.95% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NEW ENGLAND, LLC | 299 BALLARDVALE STREET WILMINGTON, MA 01887 | DELTA SERVICE OF MASSACHUSETTS, INC. DBA DELTA DENTAL OF MA | $5K | $0 | $5K | 4.84% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NEW ENGLAND LLC | 299 BALLARDVALE STREET WILMINGTON, MA 01887 | SUN LIFE ASSURANCE COMPANY OF CANADA | $8K | $0 | $8K | 8.00% |
| MGIS3 | 111 SOUTH MAIN STREET, SUITE 400 SALT LAKE CITY, UT 84111 | SUN LIFE ASSURANCE COMPANY OF CANADA | $0 | $180 | $180 | 0.17% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NEW ENGLAND LLC | 100 CENTRAL STREET, SUITE 201 HOLLISTON, MA 01746 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $6K | $0 | $6K | 8.55% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATINAL MIDWEST LIMITED | 3635 RIVERSIDE PLAZA DRIVE SUITE 300 RIVERSIDE, CA 92506 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $1K | $0 | $1K | 1.99% |
| IMG5 | 2960 NORTH MERIDIAN STREET INDIANAPOLIS, IN 46208 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $0 | $21 | $21 | 0.03% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NEW ENGLAND LLC | 300 BALLARDVALE STREET WILMINGTON, MA 01887 | VISION SERVICE PLAN | $893 | $0 | $893 | 9.75% |
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 | 106 | 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) | 106 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HARVARD PILGRIM HEALTHCARE | 206 | $1.1M |
| Dental | DELTA SERVICE OF MASSACHUSETTS, INC. DBA DELTA DENTAL OF MA | 237 | $110K |
| Vision | VISION SERVICE PLAN | 59 | $9K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 106 | $72K |
| Short-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 106 | $72K |
| Long-term disability(2 contracts, 2 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 106 | $178K |
| Prescription drug | HARVARD PILGRIM HEALTHCARE | 206 | $1.1M |
| Other | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 106 | $72K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 237 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.