| 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 | $24K | $0 | $24K | 1.96% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: WALSH DUFFIELD COMPANIES, INC | 801 MAIN STREET BUFFALO, NY 14203 | METROPOLITAN LIFE INSURANCE COMPANY | $16K | $0 | $16K | 8.85% |
| USI INSURANCE SERVICES LLC3 | PO BOX 66995 VIRGINIA BEACH, VA 23466 | FIRST UNUM LIFE INSURANCE COMPANY | $167 | $0 | $167 | 1.95% |
| WOODRUFF-SAWYER & CO3 | 50 CALIFORNIA ST 12TH FLOOR SAN FRANCISCO, CA 94111 | FIRST UNUM LIFE INSURANCE COMPANY | $19 | $0 | $19 | 0.22% |
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 | 401 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 401 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | INDEPENDENT HEALTH | 300 | $1.2M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 647 | $180K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 647 | $180K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 647 | $180K |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 647 | $180K |
| Prescription drug | INDEPENDENT HEALTH | 300 | $1.2M |
| Other(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 647 | $188K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 647 | — |
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.