| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GBC BENEFITS LTD3 | 3221 COLLINSWORTH STREET FORT WORTH, TX 76107 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $65K | — | $65K | 10.78% |
| IMG5 | 2960 NORTH MERIDIAN STREET INDIANAPOLIS, IN 46208 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $63 | $63 | 0.01% |
| GBC BENEFITS LTD3 | 3221 COLLINSWORTH ST FORT WORTH, TX 76107 | STANDARD INSURANCE COMPANY | $15K | — | $15K | 9.04% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL TX INC | 3221 COLLINSWORTH STREET FORT WORTH, TX 76107 | STANDARD INSURANCE COMPANY | $1K | — | $1K | 0.88% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NE LIMITED | 1065 AVE OF THE AMERICAS NEW YORK, NY 10018 | STANDARD INSURANCE COMPANY | $762 | — | $762 | 0.46% |
| GBC BENEFITS LTD3 | 3221 COLLINSWORTH ST FORT WORTH, TX 76107 | THE STANDARD | $2K | — | $2K | 9.11% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NE LIMITED | 1065 AVE OF THE AMERICAS NEW YORK, NY 10018 | THE STANDARD | $238 | — | $238 | 0.97% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL TX INC | 3221 COLLINSWORTH STREET FORT WORTH, TX 76107 | THE STANDARD | $209 | — | $209 | 0.85% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UMR, INC. EIN 39-1995276 CLAIMS PROCESSING | Claims processing Service code 12 | — | $388K |
| VXTRA PARTNERS LLC EIN 02-0677823 BROKER | Other commissions Service code 55 | 2700 CUMBERLAND PARKWAY SUITE 140 ATLANTA, GA 30339 | $85K |
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 | 337 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 337 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | STANDARD INSURANCE COMPANY | 209 | $165K |
| Vision | THE STANDARD | 180 | $24K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 339 | $602K |
| Short-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 339 | $602K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 339 | $602K |
| Stop-loss / reinsurancereinsurance | HCC LIFE INSURANCE COMPANY | 337 | $792K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 339 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.