| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHEAST | 100 SUNNYSIDE BOULEVARD WOODBURY, NY 11797 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $5K | $167K | $172K | 2.98% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $3K | $97K | $100K | 1.73% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHEAST LIMITED | 100 SUNNYSIDE BOULEVARD WOODBURY, NY 11797 | DELTA DENTAL OF NEW JERSEY, INC. | $13K | $0 | $13K | 2.62% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHEAST | 100 SUNNYSIDE BOULEVARD WOODBURY, NY 11797 | ZURICH AMERICAN LIFE INSURANCE COMPANY | $20K | $0 | $20K | 7.24% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD, SUITE 1000 ROLLING MEADOWS, IL 60008 | ZURICH AMERICAN LIFE INSURANCE COMPANY | $5K | $0 | $5K | 1.71% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHEAST LIMITED | 100 SUNNYSIDE BOULEVARD WOODBURY, NY 11797 | METLIFE LEGAL PLANS, INC. | $2K | $0 | $2K | 6.56% |
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 | 1,778 | 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) | 1,778 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 829 | $5.8M |
| Dental(2 contracts, 2 carriers) | DELTA DENTAL OF NEW JERSEY, INC. | 1,008 | $504K |
| Vision | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 829 | $5.8M |
| Life insurance | ZURICH AMERICAN LIFE INSURANCE COMPANY | 677 | $281K |
| Long-term disability | ZURICH AMERICAN LIFE INSURANCE COMPANY | 677 | $281K |
| Prescription drug | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 829 | $5.8M |
| Other(4 contracts, 4 carriers) | ZURICH AMERICAN LIFE INSURANCE COMPANY | 1,778 | $317K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,778 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
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.