| 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 | $28K | $0 | $28K | 1.96% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: WALSH DUFFIELD COMPANIES, INC. | 801 MAIN STREET BUFFALO, NY 142031215 | METROPOLITAN LIFE INSURANCE COMPANY | $17K | $866 | $17K | 9.35% |
| WOODRUFF-SAWYER & CO3 Filed as: WOODRUFF - SAWYER & CO | 50 CALIFORNIA ST FL 12 SAN FRANCISCO, CA 941114646 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $32 | $32 | 0.02% |
| FIRST NIAGARA RISK MANAGEMENT3 | 1215 MANOR DR STE 200 MECHANICSBURG, PA 17055 | FIRST UNUM LIFE INSURANCE COMPANY | $190 | $0 | $190 | 1.37% |
| WOODRUFF-SAWYER & CO3 Filed as: WOODRUFF - SAWYER & CO | 50 CALIFORNIA ST 12TH FLOOR SAN FRANCISCO, CA 94111 | FIRST UNUM LIFE INSURANCE COMPANY | $88 | $0 | $88 | 0.64% |
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 | 470 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 470 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | INDEPENDENT HEALTH | 368 | $1.4M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 682 | $187K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 682 | $187K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 682 | $187K |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 682 | $187K |
| Prescription drug | INDEPENDENT HEALTH | 368 | $1.4M |
| Other(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 682 | $201K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 682 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.