| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | PO BOX 6030 PASADENA, CA 91102 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $730 | $730 | 1.74% |
| MARSH & MCLENNAN AGENCY LLC3 | 9171 TOWNE CENTER DRIVE, SUITE 500 SAN DIEGO, CA 92122 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $140 | $2K | 5.08% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | PO BOX 6030 PASADENA, CA 91102 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $408 | — | $408 | 1.34% |
| BB&H BENEFIT DESIGNS3 | 109 E VICTORIA STREET SANTA BARBARA, CA 93101 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $227 | — | $227 | 0.75% |
| PANTALONE, JO, ANN3 Filed as: PANTALONE, LOUIS, JOSEPH | CUSTOM BENEFITS PROGRAMS INC. 897 12TH STREET HAMMONTON, NJ 08037 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $58 | — | $58 | 0.19% |
| CUSTOM BENEFIT PROGRAMS INC3 Filed as: CUSTOM BENEFITS PROGRAMS INC. | 897 12TH STREET HAMMONTON, NJ 08037 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $20 | $30 | $50 | 0.16% |
| BENEFIT ADVISORS NETWORK LLC3 Filed as: BENEFIT ADVISORS NETWORK | 6830 COCHRAN ROAD SOLON, OH 44139 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | — | $2 | $2 | 0.01% |
| MARSH & MCLENNAN AGENCY LLC3 | 9171 TOWNE CENTRE DRIVE, SUITE 500 SAN DIEGO, CA 92122 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $957 | — | $957 | 3.33% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | PO BOX 6030 PASADENA, CA 91102 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $617 | $617 | 2.15% |
| MARSH & MCLENNAN AGENCY LLC3 | 9171 TOWNE CENTER DRIVE, SUITE 500 SAN DIEGO, CA 92122 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $451 | $37 | $488 | 3.37% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | PO BOX 6030 PASADENA, CA 91102 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $410 | $6 | $416 | 2.87% |
| BB&H BENEFIT DESIGNS3 | 109 E VICTORIA STREET SANTA BARBARA, CA 93101 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $105 | — | $105 | 0.73% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | PO BOX 6030 PASADENA, CA 91102 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $121 | $121 | 2.03% |
| MARSH & MCLENNAN AGENCY LLC3 | 9171 TOWNE CENTRE DRIVE, SUITE 500 SAN DIEGO, CA 92122 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $110 | — | $110 | 1.85% |
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 | 362 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 363 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 276 | $2.4M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 276 | $2.4M |
| Vision | EYEMED VISION CARE | 426 | $24K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 362 | $29K |
| Short-term disability | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 72 | $30K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 361 | $42K |
| Prescription drug | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 276 | $2.4M |
| Other(3 contracts, 3 carriers) | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 362 | $51K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 426 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.