| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED Filed as: BOLTON PARTNERS | 1 W. PENNSYLVANIA AVE TOWSON, MD 21204 | THE UNION LABOR LIFE INSURANCE CO. | $3K | $11K | $14K | 4.50% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CVS CAREMARK EIN 05-0340626 SERVICE PROVIDER | Claims processing; Direct payment from the plan Service code 12 | — | $823K |
| BENEFITS ADMINISTRATION CORPORATION EIN 52-1139156 SERVICE PROVIDER | Plan Administrator; Accounting (including auditing); Direct payment from the plan; Claims processing Service code 10 | — | $225K |
| DELTA DENTAL OF PENNSYLVANIA EIN 23-1667011 SERVICE PROVIDER | Direct payment from the plan; Contract Administrator Service code 13 | — | $174K |
| SARFINO AND RHOADES, LLP EIN 52-0961657 SERVICE PROVIDER | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $48K |
| O'DONOGHUE AND O'DONOGHUE EIN 53-0120528 SERVICE PROVIDER | Legal; Direct payment from the plan Service code 29 | — | $46K |
| CALL A DOCTOR SERVICE PROVIDER | Contract Administrator; Direct payment from the plan Service code 13 | 166 ALBANY TURNPIKE, SUITE 8 CANTON, CT 06019 | $44K |
| CFA, LLC SERVICE PROVIDER | Contract Administrator; Direct payment from the plan Service code 13 | 10455 MILL RUN ROAD OWINGS MILLS, MD 21117 | $28K |
| BOLTON PARTNERS, INC. EIN 52-1231144 SERVICE PROVIDER | Consulting (general); Actuarial; Direct payment from the plan Service code 11 | — | $22K |
| ZELIS CLAIMS INTEGRITY EIN 86-1040704 SERVICE PROVIDER | Direct payment from the plan; Contract Administrator Service code 13 | — | $18K |
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 | 464 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 69 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 533 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | VISION SERVICE PLAN | 533 | $0 |
| Life insurance | THE UNION LABOR LIFE INSURANCE CO. | 500 | $66K |
| Stop-loss / reinsurancereinsurance | THE UNION LABOR LIFE INSURANCE CO. | 482 | $304K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 533 | — |
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."
No prospect flags tripped on this filing.