| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON PARTNERS, INC. | 36 S. CHARLES STREET, SUITE 1000 BALTIMORE, MD 21201 | THE UNION LABOR LIFE INSURANCE COMPANY | $5K | $0 | $5K | 1.50% |
| NATIONAL CAPITAL INSURANCE AGENCY3 | P.O. BOX 3065 FAIRFAX, VA 220383065 | DEARBORN NATIONAL LIFE INSURANCE COMPANY | $0 | $2K | $2K | 1.62% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CAREFIRST BLUECROSS BLUESHIELD EIN 52-1385894 NONE | Direct payment from the plan; Other fees; Claims processing Service code 12 | 10455 MILL RUN CIRCLE OWINGS MILLS, MD 21117 | $3.3M |
| AMERICAN HEALTH HOLDINGS EIN 31-1368946 NONE | Direct payment from the plan; Other services Service code 49 | 100 W. OLD WILSON BRIDGE ROAD WORTHINGTON, OH 430856015 | $73K |
| INNOVATIVE SOFTWARE SOLUTIONS EIN 23-2182079 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.); Direct payment from the plan Service code 15 | 2 EXECUTIVE CAMPUS, SUITE 400 CHERRY HILL, NJ 08002 | $69K |
| SHARON DAINES EIN 52-6048847 PLAN EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $61K |
| ROSANNA CAVANAUGH EIN 52-6048847 PLAN EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $37K |
| SABRINA CALVERT EIN 52-6048847 PLAN EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $37K |
| LISA SHUEY EIN 52-6048847 PLAN EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $36K |
| TAMMY PATTON EIN 52-6048847 PLAN EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $36K |
| WILMINGTON TRUST / M&T BANK EIN 16-0538020 NONE | Investment management; Investment management fees paid directly by plan; Custodial (securities) Service code 19 | — | $31K |
| WEYRICH, CRONIN & SORRA, LLC EIN 81-4643077 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $24K |
| BOLTON PARTNERS, INC. EIN 52-1231144 NONE | Direct payment from the plan; Actuarial Service code 11 | — | $23K |
| INVESCO ADVISERS INC. EIN 58-1707262 NONE | Soft dollars commissions; Investment management Service code 28 | — | $22K |
| FAMOUS AND SPANG ASSOCIATES EIN 52-1202946 NONE | Insurance services; Insurance agents and brokers Service code 22 | 200 W. BELAIR AVENUE, P.O. BOX 458 ABERDEEN, MD 21117 | $15K |
| ABATO, RUBENSTEIN & ABATO EIN 52-0904713 NONE | Insurance agents and brokers; Direct payment from the plan Service code 22 | — | $12K |
| REYNOLDS CONSULTING SERVICES, LLC. EIN 20-1899564 NONE | Direct payment from the plan; Investment advisory (plan) Service code 27 | — | $9K |
| ASMED HEALTH, LLC EIN 27-4189010 | Other services; Direct payment from the plan Service code 49 | — | $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 | 1,552 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 12 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 1,564 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | DEARBORN NATIONAL LIFE INSURANCE COMPANY | 1,631 | $128K |
| Long-term disability | DEARBORN NATIONAL LIFE INSURANCE COMPANY | 1,631 | $128K |
| Stop-loss / reinsurancereinsurance | THE UNION LABOR LIFE INSURANCE COMPANY | 1,540 | $333K |
| Other | DEARBORN NATIONAL LIFE INSURANCE COMPANY | 1,631 | $128K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,631 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.