| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| 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 | $30K | $9K | $39K | 18.74% |
| JENNINGS INSURANCE SERVICES3 | 618 E SOUTH STREET ORLANDO, FL 32801 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $650 | — | $650 | 0.31% |
| EMPLOYEE FAMILY PROTECTION INC3 | ATTN MICHAEL STEPNOWSKI PO BOX 1237 GLASTONBURY, CT 06033 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $31K | $4K | $35K | 46.09% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: TIS INSURANCE SERVICE, INC. | 1900 NORTH WINSTON ROAD SUITE 100 PO BOX 10328 KNOXVILLE, TN 37919 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $13K | $646 | $14K | 18.12% |
| EMPLOYEE FAMILY PROTECTION INC3 | ATTN MICHAEL STEPNOWSKI PO BOX 1237 GLASTONBURY, CT 06033 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $21K | $2K | $23K | 63.70% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: TIS INSURANCE SERVICE, INC. | 1900 NORTH WINSTON ROAD SUITE 100 PO BOX 10328 KNOXVILLE, TN 37919 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $9K | $303 | $9K | 25.65% |
| BENEFIT ADVISORS NETWORK LLC3 Filed as: BENEFIT ADVISORS NETWORK | 6830 COCHRAN ROAD SOLON, OH 44139 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | — | $303 | $303 | 0.83% |
No Schedule C service providers reported on this filing.
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 | 172 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 172 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 250 | $207K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 250 | $207K |
| Short-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 250 | $207K |
| Long-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 250 | $207K |
| Stop-loss / reinsurancereinsurance | NATIONWIDE LIFE INSURANCE COMPANY | 137 | $373K |
| Other(4 contracts, 4 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 348 | $321K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 348 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.