| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ASSUREDPARTNERS3 Filed as: AP BENEFIT ADVISORS, LLC DBA P | 200 INTERNATIONAL CR SUITE 4500 HUNT VALLEY, MD 21031 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $63K | — | $63K | 13.19% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: TIS INSURANCE SERVICES, INC | 1900 WINSTON RD SUITE 100 KNOXVILLE, TN 37919 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $25K | — | $25K | 5.31% |
| PHILLIP PORTER GOODRUM3 | 131 HILLSIDE AVE CHARLOTTE, NC 28209 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $10K | — | $10K | 2.11% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: TIS INSURANCE SERVICES, INC | 1900 WINSTON RD SUITE 100 KNOXVILLE, TN 37919 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $7K | — | $7K | 1.41% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD HEALTHCARE EIN 58-1638390 HEALTH ADMIN | Recordkeeping fees; Recordkeeping and information management (computing, tabulating, data processing, etc.); Contract Administrator; Other services; Float revenue; Claims processing Service code 12 | — | $357K |
| AP BENEFIT ADVISORS LLC EIN 58-1638390 BROKER | Other commissions; Insurance agents and brokers; Insurance brokerage commissions and fees Service code 22 | — | $118K |
| INGENIO RX EIN 82-3062245 PRESCRIPTION DRUG | Float revenue; Recordkeeping and information management (computing, tabulating, data processing, etc.); Contract Administrator; Other services; Claims processing Service code 12 | — | -$43K |
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 | 391 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 23 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 416 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 391 | $476K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 391 | $476K |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 391 | $476K |
| Short-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 391 | $476K |
| Long-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 391 | $476K |
| Other | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 391 | $476K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 391 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.