| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NEW ENGLAND LLC | UNKNOWN NORTH ANDOVER, MA 01845 | HARVARD PILGRIM HEALTH CARE | $42K | $0 | $42K | 3.38% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NEW ENGLAND LLC | 299 BALLARDVALE STREET, SUITE 2 WILMINGTON, MA 01887 | DELTA SERVICE OF MASSACHUSETTS, INC. DBA DELTA DENTAL OF MA | $5K | $0 | $5K | 4.37% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NEW ENGLAND LLC | 299 BALLARDVALE STREET, SUITE 2 WILMINGTON, CO 01887 | SUN LIFE ASSURANCE COMPANY OF CANADA | $9K | $0 | $9K | 8.00% |
| MGIS3 | 111 SOUTH MAIN STREET, SUITE 400 SALT LAKE CITY, UT 84111 | SUN LIFE ASSURANCE COMPANY OF CANADA | $0 | $180 | $180 | 0.15% |
| 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 | 9.36% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 3635 RIVERSIDE PLAZA DRIVE SUITE 300 RIVERSIDE, CA 92506 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $0 | $2K | $2K | 3.06% |
| IMG5 | 2960 NORTH MERIDIAN STREET INDIANAPOLIS, IN 46208 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $0 | $19 | $19 | 0.03% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NEW ENGLAND LLC | 300 BALLARDVALE STREET WILMINGTON, MA 01887 | VISION SERVICE PLAN | $833 | $0 | $833 | 7.53% |
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 | 108 | 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) | 108 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HARVARD PILGRIM HEALTH CARE | 146 | $1.2M |
| Dental | DELTA SERVICE OF MASSACHUSETTS, INC. DBA DELTA DENTAL OF MA | 259 | $121K |
| Vision | VISION SERVICE PLAN | 69 | $11K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 108 | $63K |
| Short-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 108 | $63K |
| Long-term disability(2 contracts, 2 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 108 | $179K |
| Prescription drug | HARVARD PILGRIM HEALTH CARE | 146 | $1.2M |
| Other | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 108 | $63K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 259 | — |
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."
No prospect flags tripped on this filing.