| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON PARTNERS, INC. | BUILDING 5 WEST, SUITE 200 BLUE BELL, PA 19422 | THE UNION LABOR LIFE INSURANCE COMPANY | $3K | — | $3K | 3.27% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UMR, INC. EIN 39-1995276 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $101K |
| BLITMAN & KING, LLP EIN 16-1047304 NONE | Legal; Direct payment from the plan Service code 29 | — | $46K |
| SEI EIN 23-1707341 NONE | Investment management fees paid directly by plan; Investment management Service code 28 | — | $32K |
| JOSEPH MCCARTHY & ASSOCIATES EIN 16-1120588 NONE | Direct payment from the plan; Other services Service code 49 | — | $31K |
| RENEE SAGER EIN 16-6044095 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $31K |
| TOBIE WEILAND EIN 16-6044095 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $29K |
| BOLTON PARTNERS EIN 22-3502478 NONE | Direct payment from the plan; Actuarial Service code 11 | — | $28K |
| JENNIFER MARTELL EIN 16-6044095 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $21K |
| DERMODY, BURKE & BROWN, CPAS, LLC EIN 01-0723685 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $18K |
| JBM COMPUTER CONSULTANTS EIN 16-1173118 NONE | Direct payment from the plan; Consulting (general) Service code 16 | — | $17K |
| INTEGRA CONSULTING, INC. EIN 16-1600723 NONE | Direct payment from the plan; Consulting (general) Service code 16 | — | $11K |
| DELTA DENTAL EIN 11-1980218 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $5K |
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 | 197 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 196 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 107 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 500 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Stop-loss / reinsurancereinsurance | THE UNION LABOR LIFE INSURANCE COMPANY | 204 | $89K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 204 | — |
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.