| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHEAST LIMITED | 401 BROADHOLLOW ROAD MELVILLE, NY 11747 | ANTHEM BLUE CROSS AND BLUE SHIELD (G1921) | $127K | $0 | $127K | 3.47% |
| FNA INSURANCE SERVICES INC3 | 1000 WOODBURY ROAD SUITE 403 WOODBURY, NY 11797 | ANTHEM BLUE CROSS AND BLUE SHIELD (G1921) | $0 | $48K | $48K | 1.31% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SVS INC | PO BOX 2158 RIVERSIDE, CA 92516 | ANTHEM BLUE CROSS AND BLUE SHIELD (G1921) | $0 | $5K | $5K | 0.12% |
| FNA INSURANCE SERVICES INC3 | 180 RIVER ROAD FLOOR 2 SUMMIT, NJ 07901 | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $33K | $4K | $38K | 21.79% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST LTD | 3390 UNIVERSITY AVE, SUITE 300 RIVERSIDE, CA 92501 | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $34K | $0 | $34K | 19.49% |
| JAMES R NELLIGAN & ASSOCIATES LLC3 Filed as: JAMES R NELLIGAN ASSOCIATES | 1060 BROADWAY SUITE 400 ALBANY, NY 12204 | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $92 | $0 | $92 | 0.05% |
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 | 250 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 1 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 251 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | ANTHEM BLUE CROSS AND BLUE SHIELD (G1921) | 221 | $3.7M |
| Dental | ANTHEM BLUE CROSS AND BLUE SHIELD (G1921) | 221 | $3.7M |
| Vision | ANTHEM BLUE CROSS AND BLUE SHIELD (G1921) | 221 | $3.7M |
| Life insurance | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 417 | $173K |
| Short-term disability | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 417 | $173K |
| Long-term disability | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 417 | $173K |
| Other(2 contracts, 2 carriers) | ANTHEM BLUE CROSS AND BLUE SHIELD (G1921) | 417 | $3.8M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 417 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.