| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MID SOUTH | 3011 ARMORY DRIVE SUITE 250 NASHVILLE, TN 37204 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $23K | $6K | $29K | 14.68% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL - MID SOUTH | 3011 ARMORY DRIVE, SUITE 250 NASHVILLE, TN 37204 | SURENCY LIFE AND HEALTH | $3K | — | $3K | 9.88% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| MERITAIN HEALTH, INC. CONTRACT ADMINISTRATOR | Direct payment from the plan; Contract Administrator Service code 13 | P.O. BOX 853921 RICHARDSON, TX 75085 | $643K |
| ONE MEDICAL GROUP PC EIN 81-2141065 EMPLOYEE CLINIC | Other services; Direct payment from the plan Service code 49 | — | $85K |
| GINGER IO OF CA MEDICAL P.C. EIN 47-5231010 MEDICAL VENDOR | Direct payment from the plan; Contract Administrator Service code 13 | — | $38K |
| NOVAK BIRKS P.C. EIN 43-1122456 AUDITOR | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $13K |
| HEALTH JOY EIN 46-5722012 TELEMEDICINE | Direct payment from the plan; Contract Administrator Service code 13 | — | $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 | 207 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 5 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 212 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | SURENCY LIFE AND HEALTH | 186 | $32K |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 205 | $200K |
| Long-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 205 | $200K |
| Stop-loss / reinsurancereinsurance | HCC LIFE INSURANCE COMPANY | 169 | $492K |
| Other | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 205 | $200K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 205 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.