| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON PARTNERS NORTHEAST | 36 S CHARLES STREET, SUITE 1000 BALTIMORE, MD 21201 | EXCELLUS BLUECROSS BLUESHIELD | $68K | — | $68K | 3.74% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON PARTNERS NORTHEAST | 36 S CHARLES STREET, SUITE 1000 BALTIMORE, MD 21201 | EXCELLUS BLUECROSS BLUESHIELD | $2K | — | $2K | 2.98% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ANTHONY NOYER EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $82K |
| BONADIO & CO., LLP EIN 16-1131146 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $65K |
| CARLOS MARTINEZ EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $55K |
| KARPUS INVESTMENT MANAGERS EIN 16-1290558 NONE | Direct payment from the plan; Investment management Service code 28 | — | $53K |
| MORGAN STANLEY EIN 13-2919773 NONE | Direct payment from the plan; Custodial (securities); Investment advisory (plan) Service code 19 | — | $41K |
| ROOFERS LOCAL 22 BUILDING FUND EIN 26-2543715 AFFILIATE | Other services; Direct payment from the plan Service code 49 | — | $18K |
| ROBERT PIZZO, ESQ. EIN 82-0553395 NONE | Legal; Direct payment from the plan Service code 29 | — | $16K |
| TELPERION SOLUTIONS GROUP NONE | Direct payment from the plan; Other services Service code 49 | 311 ALEXANDER STREET ROCHESTER, NY 14604 | $8K |
| PILOT CONSULTING, INC EIN 20-2520069 NONE | Direct payment from the plan; Other services Service code 49 | — | $7K |
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 | 119 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 11 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 130 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts) | EXCELLUS BLUECROSS BLUESHIELD | 120 | $1.9M |
| Life insurance | THE UNION LABOR LIFE INSURANCE COMPANY | 124 | $4K |
| Prescription drug(2 contracts) | EXCELLUS BLUECROSS BLUESHIELD | 120 | $1.9M |
| Other | THE UNION LABOR LIFE INSURANCE COMPANY | 124 | $4K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 124 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.