| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST | PO BOX 6650 METAIRIE, LA 700096650 | STARMOUNT LIFE INSURANCE COMPANY | $23K | — | $23K | 5.29% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES LLC | PO BOX 123042 DALLAS, TX 753123042 | STARMOUNT LIFE INSURANCE COMPANY | $6K | — | $6K | 1.35% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST | PO BOX 6650 METAIRIE, LA 70009 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $36K | $5K | $41K | 12.55% |
| LOCKTON COMPANIES, LLC Filed as: LOCKTON COMPANIES LLC | 2100 ROSS AVE STE 1200 DALLAS, TX 75201 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $13K | — | $13K | 3.96% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST | PO BOX 6650 METAIRIE, LA 70009 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $8K | $2K | $10K | 9.12% |
| LOCKTON COMPANIES, LLC Filed as: LOCKTON COMPANIES LLC | 2100 ROSS AVE STE 1200 DALLAS, TX 75201 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | — | $3K | 2.68% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST | PO BOX 6650 METAIRIE, LA 700096650 | STARMOUNT LIFE INSURANCE COMPANY | $5K | — | $5K | 6.21% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES LLC | PO BOX 123042 DALLAS, TX 753123042 | STARMOUNT LIFE INSURANCE COMPANY | $1K | — | $1K | 1.58% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST | PO BOX 6650 METAIRIE, LA 70009 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $5K | $1K | $6K | 9.45% |
| LOCKTON COMPANIES, LLC Filed as: LOCKTON COMPANIES LLC | 2100 ROSS AVE STE 1200 DALLAS, TX 75201 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | — | $2K | 2.64% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST | PO BOX 6650 METAIRIE, LA 70009 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $7K | $954 | $8K | 13.29% |
| LOCKTON COMPANIES, LLC Filed as: LOCKTON COMPANIES LLC | 2100 ROSS AVE STE 1200 DALLAS, TX 75201 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | — | $2K | 3.74% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BCBS OF SOUTH CAROLINA EIN 57-0287420 CLAIMS PROCESSOR | Claims processing Service code 12 | 51 CLEMSON ROAD COLUMBIA, SC 29229 | $0 |
| BENEFIT FOCUS EIN 42-2346314 RECORD KEEPING, INFO MGT | Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | 100 BENEFITFOCUS WAY CHARLESTON, SC 29492 | $0 |
| EAP HIDALGO EIN 72-1380740 EMPLOYEE ASSISTANCE PROGR | Other fees Service code 99 | 4637 JAMESTOWN AVENUE BATON ROUGE, LA 70808 | $0 |
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 | 797 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 22 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 819 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA | 844 | $4.5M |
| Dental | STARMOUNT LIFE INSURANCE COMPANY | 654 | $428K |
| Vision | STARMOUNT LIFE INSURANCE COMPANY | 580 | $74K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 804 | $325K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 687 | $67K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 687 | $110K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA | 844 | $4.5M |
| Other | LIFE INSURANCE COMPANY OF NORTH AMERICA | 804 | $58K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 844 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.