| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: WALSH DUFFIELD COMPANIES INC. | 801 MAIN STREET BUFFALO, NY 14203 | INDEPENDENT HEALTH BENEFITS CORPORATION | $64K | $0 | $64K | 2.17% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: WALSH DUFFIELD COMPANIES INC. | 801 MAIN STREET BUFFALO, NY 14203 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $12K | $0 | $12K | 6.65% |
| LAWLEY BENEFITS GROUP LLC3 Filed as: LAWLEY | 361 DELAWARE AVE. BUFFALO, NY 14202 | LINCOLN NATIONAL LIFE INSURANCE COMPANY | $4K | $3K | $7K | 12.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| NOVA HEALTHCARE ADMINISTRATORS, INC EIN 16-6443379 ADMINISTRATOR | Contract Administrator Service code 13 | — | $15K |
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 | 480 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 480 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | INDEPENDENT HEALTH BENEFITS CORPORATION | 440 | $2.9M |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 309 | $176K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 309 | $176K |
| Life insurance(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 480 | $233K |
| Short-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 309 | $176K |
| Prescription drug | INDEPENDENT HEALTH BENEFITS CORPORATION | 440 | $2.9M |
| Other(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 480 | $233K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 480 | — |
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.