| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON PARTNERS, INC. | 100 LIGHT ST FL 9 BALTIMORE, MD 21202 | RELIASTAR LIFE INSURANCE COMPANY | $4K | — | $4K | 1.83% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| EXPRESS SCRIPTS, INC. EIN 43-1420563 SERVICE PROVIDER | Claims processing; Direct payment from the plan Service code 12 | — | $1.1M |
| EMPLOYEES OF IATSE LOCAL 22 WELFARE EIN 52-1021473 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $89K |
| BENEFITS ADMINISTRATION CORPORATION EIN 52-1139156 SERVICE PROVIDER | Direct payment from the plan; Claims processing Service code 12 | — | $78K |
| O'DONOGHUE AND O'DONOGHUE EIN 53-0120528 SERVICE PROVIDER | Legal; Direct payment from the plan Service code 29 | — | $56K |
| AMERICA HEALTH HOLDINGS, INC. EIN 31-1368946 SERVICE PROVIDER | Direct payment from the plan; Contract Administrator Service code 13 | — | $34K |
| BOLTON PARTNERS, INC. EIN 52-1231144 SERVICE PROVIDER | Actuarial; Direct payment from the plan Service code 11 | — | $31K |
| SARFINO AND RHOADES, LLP EIN 52-0961657 SERVICE PROVIDER | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $29K |
| A&S FINANCIAL SERVICES, LLC EIN 27-4189010 SERVICE PROVIDER | Direct payment from the plan; Contract Administrator Service code 13 | — | $27K |
| NCAS SERVICE PROVIDER | Direct payment from the plan; Contract Administrator Service code 13 | 10455 MILL RUN ROAD OWINGS MILLS, MD 21117 | $19K |
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 | 291 | Currently employed and enrolled or eligible. |
| Retired/separated still eligible | 52 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 343 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF PENNSYLVANIA | 324 | $109K |
| Vision | VISION SERVICE PLAN | 326 | $0 |
| Life insurance | RELIASTAR LIFE INSURANCE COMPANY | 325 | $245K |
| Stop-loss / reinsurancereinsurance | RELIASTAR LIFE INSURANCE COMPANY | 325 | $245K |
| Other | RELIASTAR LIFE INSURANCE COMPANY | 325 | $245K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 326 | — |
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.