| 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 | $40K | $0 | $40K | 1.93% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: WALSH DUFFIELD COMPANIES INC. | 801 MAIN STREET BUFFALO, NY 14203 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $11K | $0 | $11K | 6.65% |
| LAWLEY BENEFITS GROUP LLC3 Filed as: LAWLEY, LLC | 361 DELAWARE AVE. BUFFALO, NY 14202 | LINCOLN NATIONAL LIFE INSURANCE COMPANY | $10K | $2K | $12K | 18.22% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| PHARMACY BENEFIT DIMENSIONS EIN 65-1261165 ADMINISTRATOR | Contract Administrator Service code 13 | — | $24K |
| NOVA HEALTHCARE ADMINISTRATORS, INC EIN 16-6443379 ADMINISTRATOR | Contract Administrator Service code 13 | — | $16K |
| WALSH DUFFIELD COMPANIES, INC. EIN 16-0413770 BROKER | Insurance agents and brokers Service code 22 | — | $16K |
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 | 523 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 523 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | INDEPENDENT HEALTH BENEFITS CORPORATION | 445 | $2.1M |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 296 | $169K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 296 | $169K |
| Life insurance(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 523 | $238K |
| Short-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 296 | $169K |
| Other(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 523 | $238K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 523 | — |
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.