| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GBS BENEFITS INC3 Filed as: GBS BENEFITS | 2200 S. MAIN STREET STE 600 SOUTH SALT LAKE, UT 84115 | SELECTHEALTH | $6K | $1K | $7K | 3.33% |
| HUB INTERNATIONAL MIDWEST LIMITED4 Filed as: HUB INTERNATIONAL NORTHEAST LTD | 300 CONNELL DRIVE #3000 BERKELEY HEIGHTS, NJ 07922 | SUN LIFE ASSURANCE COMPANY OF CANADA | $32K | — | $32K | 15.00% |
| ENROLLEASE4 Filed as: ONE DIGITAL PREMIER SERVICES | 400 BERWYN PARK 200/899 CASSATT RD BERWYN, PA 19312 | SUN LIFE ASSURANCE COMPANY OF CANADA | $9K | — | $9K | 4.00% |
| MGIS4 | 111 SOUTH MAIN STREET STE 400 SALT LAKE CITY, UT 84111 | SUN LIFE ASSURANCE COMPANY OF CANADA | $0 | $120 | $120 | 0.06% |
| GBS BENEFITS INC3 Filed as: GBS BENEFITS | 2200 S. MAIN STREET STE 600 SOUTH SALT LAKE, UT 84115 | AMERITAS LIFE INSURANCE GROUP | $15K | $5K | $19K | 9.88% |
| LEAVITT GROUP3 Filed as: DIXIE LEAVITT AGENCY | 115 N MAIN ST CEDAR CITY, UT 84720 | AMERITAS LIFE INSURANCE GROUP | $0 | $2K | $2K | 1.19% |
| HOLLOWTREE HOLDINGS CORPORATION3 | 840 HOLLOW TREE RIDGE ROAD DARIEN, CT 06820 | RELIANCE MATRIX | $18K | $0 | $18K | 13.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHEAST LTD | 300 CONNELL DRIVE #3000 BERKELEY HEIGHTS, NJ 07922 | RELIANCE MATRIX | $9K | $0 | $9K | 7.00% |
| MGIS3 | 111 SOUTH MAIN STREET STE 400 SALT LAKE CITY, UT 84111 | RELIANCE MATRIX | $0 | $60 | $60 | 0.04% |
| HUB INTERNATIONAL MIDWEST LIMITED4 Filed as: HUB INTERNATIONAL NORTHEAST LTD | 300 CONNELL DRIVE #3000 BERKELEY HEIGHTS, NJ 07922 | SUN LIFE ASSURANCE COMPANY OF CANADA | $456 | $0 | $456 | 14.99% |
| ENROLLEASE4 Filed as: ONE DIGITAL PREMIER SERVICES | 400 BERWYN PARK 200/899 CASSATT RD BERWYN, PA 19312 | SUN LIFE ASSURANCE COMPANY OF CANADA | $152 | — | $152 | 5.00% |
| HOLLOWTREE HOLDINGS CORPORATION3 | 840 HOLLOW TREE RIDGE ROAD DARIEN, CT 06820 | RELIANCE MATRIX | $324 | $0 | $324 | 13.02% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHEAST LTD | 300 CONNELL DRIVE #3000 BERKELEY HEIGHTS, NJ 07922 | RELIANCE MATRIX | $174 | $0 | $174 | 6.99% |
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 | 140 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 141 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | SELECTHEALTH | 47 | $224K |
| Dental | AMERITAS LIFE INSURANCE GROUP | 294 | $194K |
| Vision | AMERITAS LIFE INSURANCE GROUP | 294 | $194K |
| Short-term disability(2 contracts, 2 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 17 | $6K |
| Long-term disability(2 contracts, 2 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 98 | $350K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 294 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.