| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 | 2120 PEWAUKEE RD STE 202 WAUKESHA, WI 531882491 | BLUE CROSS BLUE SHIELD HEALTHCARE PLAN OF GEORGIA, INC. | $305K | — | $305K | 3.78% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SERVICE | PO BOX 4047 CONCORD, CA 94524 | BLUE CROSS BLUE SHIELD HEALTHCARE PLAN OF GEORGIA, INC. | — | $15K | $15K | 0.19% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST LTD | 333 N. GREENE STREET SUITE 101 GREENSBORO, NC 27401 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $19K | — | $19K | 10.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL CAROLINA | 1001 MOREHEAD SQUARE DRIVE SUITE 400 CHARLOTTE, NC 28278 | GUARDIAN | $28K | $2K | $30K | 19.32% |
| THE CASON GROUP INC3 Filed as: THE CASON GROUP, INC. | 1612 MARION STREET 4TH FLOOR COLUMBIA, SC 29201 | GUARDIAN | $28K | — | $28K | 17.96% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST LTD | 333 N GREENE STREET, SUITE 101 GREENSBORO, NC 27401 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $8K | — | $8K | 10.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST LTD | 333 N. GREENE STREET SUITE 101 GREENSBORO, NC 27401 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $2K | — | $2K | 15.00% |
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 | 2,095 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 2,097 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD HEALTHCARE PLAN OF GEORGIA, INC. | 1,074 | $8.1M |
| Dental | BLUE CROSS BLUE SHIELD HEALTHCARE PLAN OF GEORGIA, INC. | 1,074 | $8.1M |
| Vision | BLUE CROSS BLUE SHIELD HEALTHCARE PLAN OF GEORGIA, INC. | 1,074 | $8.1M |
| Life insurance(2 contracts) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 2,095 | $100K |
| Short-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 263 | $193K |
| Other(2 contracts, 2 carriers) | GUARDIAN | 2,095 | $238K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,095 | — |
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.