| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL LIMITED | 210 SIXTH AVENUE 30TH FLOOR PITTSBURGH, PA 15222 | UPMC HEALTH OPTIONS | $20K | — | $20K | 2.41% |
| ASSUREDPARTNERS3 Filed as: THE HDH GROUP INC | 210 SIXTH AVENUE 30TH FLOOR PITTSBURGH, PA 15222 | DEARBORN LIFE INSURANCE COMPANY | $1K | — | $1K | 12.68% |
| LOESEL-SCHAAF INSURANCE AGENCY INC3 | 3537 WEST 12TH STREET ERIE, PA 16505 | DEARBORN LIFE INSURANCE COMPANY | $251 | $323 | $574 | 5.03% |
| ASSUREDPARTNERS3 Filed as: THE HDH GROUP, INC | 210 SIXTH AVENUE 30TH FLOOR PITTSBURGH, PA 15222 | NGL | $477 | — | $477 | 5.00% |
| ASSUREDPARTNERS3 Filed as: THE HDH GROUP, INC | 210 SIXTH AVENUE 30TH FLOOR PITTSBURGH, PA 15222 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $588 | — | $588 | 15.01% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| THE HDH GROUP, INC DBA HUB INTL EIN 25-1428002 CLAIMS PROCESSOR | Direct payment from the plan; Claims processing; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | — | $6K |
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 | 127 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 128 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UPMC HEALTH OPTIONS | 125 | $849K |
| Vision | NGL | 152 | $10K |
| Life insurance | DEARBORN LIFE INSURANCE COMPANY | 127 | $11K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 8 | $4K |
| Other | DEARBORN LIFE INSURANCE COMPANY | 127 | $11K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 152 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.