| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WENDY PACE3 | 6068 LITTLE MOUNTAN ROAD CLOVER, SC 29710 | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | $22K | $0 | $22K | 1.72% |
| ROBERT CONDRON3 | 402 SPRINGCREST DR ROCK HILL, SC 29715 | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | $22K | $0 | $22K | 1.70% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST LTD | PO BOX 2158 RIVERSIDE, CA 92516 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4K | $2K | $6K | 5.71% |
| CONDRON, ROBERT J3 | 402 SPRINGCREST DR FORT MILL, SC 29715 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $5K | $0 | $5K | 5.34% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST LTD | PO BOX 2158 RIVERSIDE, CA 92516 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $765 | $3K | 10.88% |
| CONDRON, ROBERT J3 | 402 SPRINGCREST DR FORT MILL, SC 29715 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $0 | $2K | 6.84% |
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 | 136 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 136 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | 336 | $1.3M |
| Dental | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | 336 | $1.3M |
| Vision | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | 336 | $1.3M |
| Life insurance(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 136 | $130K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 136 | $101K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 136 | $101K |
| Prescription drug | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | 336 | $1.3M |
| Other(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 136 | $130K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 336 | — |
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.