| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: WALSH DUFFIELD COMPANIES, INC. | 801 MAIN ST. BUFFALO, NY 14203 | HIGHMARK WESTERN AND NORTHEASTERN NEW YORK, INC. | $52K | — | $52K | 1.09% |
| JAMES R NELLIGAN & ASSOCIATES LLC3 Filed as: JAMES R. NELLIGAN & ASSOC. LLC | 1933 STATE ROUTE 35 STE 368 WALL, NJ 07719 | HARTFORD LIFE AND ACCIDENT | — | $31K | $31K | 6.22% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: WALSH DUFFIELD CO., INC. | 726 EXCHANGE ST. STE 200 BUFFALO, NY 14210 | HARTFORD LIFE AND ACCIDENT | $13K | — | $13K | 2.62% |
| JAMES R NELLIGAN & ASSOCIATES LLC3 Filed as: JAMES R. NELLIGAN & ASSOC., LLC | 1933 STATE ROUTE 35 STE 368 WALL, NJ 07719 | DELTA DENTAL OF NEW YORK | $9K | — | $9K | 5.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: WALSH DUFFIELD COMPANIES, INC. | 801 MAIN ST. BUFFALO, NY 14203 | DELTA DENTAL OF NEW YORK | $9K | — | $9K | 5.00% |
| JAMES R NELLIGAN & ASSOCIATES LLC3 Filed as: JAMES R. NELLIGAN & ASSOC., LLC | 1933 STATE ROUTE 35 STE 368 WALL, NJ 07719 | VISION SERVICE PLAN | $2K | — | $2K | 4.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: WALSH DUFFIELD, CO., INC. | 801 MAIN ST. BUFFALO, NY 14203 | THE PAUL REVERE LIFE INSURANCE COMPANY | $603 | — | $603 | 9.54% |
| THE MCCLAIN GROUP LLC3 Filed as: THE MCCLAIN GROUP, LLC | 104 WITHEROW RD. SEWICKLEY, PA 15143 | THE PAUL REVERE LIFE INSURANCE COMPANY | $472 | — | $472 | 7.47% |
| TIMOTHY BIRDSONG3 | 302 FIELDBROOK DR. WASHINGTON, PA 15301 | THE PAUL REVERE LIFE INSURANCE COMPANY | $15 | $9 | $24 | 0.38% |
| DONNA TROXELL3 | 526 SCAIFE RD. SEWICKLEY, PA 15143 | THE PAUL REVERE LIFE INSURANCE COMPANY | $11 | — | $11 | 0.17% |
| THE MCCLAIN GROUP LLC3 Filed as: THE MCCLAIN GROUP, LLC | 104 WITHEROW RD. SEWICKLEY, PA 15413 | THE PAUL REVERE LIFE INSURANCE COMPANY | $279 | — | $279 | 5.72% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: WALSH DUFFIELD CO., INC. | 726 EXCHANGE ST. BUFFALO, NY 14210 | THE PAUL REVERE LIFE INSURANCE COMPANY | $270 | — | $270 | 5.53% |
| TIMOTHY BIRDSONG3 | 302 FIELDBROOK DR. WASHINGTON, PA 15301 | THE PAUL REVERE LIFE INSURANCE COMPANY | $1 | $1 | $2 | 0.04% |
| DONNA TROXELL3 | 526 SCAIFE RD. SEWICKLEY, PA 15143 | THE PAUL REVERE LIFE INSURANCE COMPANY | $1 | — | $1 | 0.02% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: WALSH DUFFIELD CO., INC. | 726 EXCHANGE ST. BUFFALO, NY 14210 | THE PAUL REVERE LIFE INSURANCE COMPANY | $402 | — | $402 | 10.54% |
| THE MCCLAIN GROUP LLC3 Filed as: THE MCCLAIN GROUP, LLC | 104 WITHEROW RD. SEWICKLEY, PA 15143 | THE PAUL REVERE LIFE INSURANCE COMPANY | $163 | — | $163 | 4.27% |
| TIMOTHY BIRDSONG3 | 302 FIELDBROOK DR. WASHINGTON, PA 15301 | THE PAUL REVERE LIFE INSURANCE COMPANY | $7 | $4 | $11 | 0.29% |
| DONNA TROXELL3 | 526 SCAIFE RD. SEWICKLEY, PA 15143 | THE PAUL REVERE LIFE INSURANCE COMPANY | $5 | — | $5 | 0.13% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: WALSH DUFFIELD CO., INC. | 726 EXCHANGE ST. BUFFALO, NY 14210 | THE PAUL REVERE LIFE INSURANCE COMPANY | $148 | — | $148 | 6.40% |
| THE MCCLAIN GROUP LLC3 Filed as: THE MCCLAIN GROUP, LLC | 104 WITHEROW RD. SEWICKLEY, PA 15143 | THE PAUL REVERE LIFE INSURANCE COMPANY | $69 | — | $69 | 2.98% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: WALSH DUFFIELD CO., INC. | 726 EXCHANGE ST. STE 200 BUFFALO, NY 14210 | FEDERAL INSURANCE COMPANY | $225 | — | $225 | 15.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CHILD AND FAMILY SERVICES EAP EIN 16-1004825 NONE | Plan Administrator Service code 14 | — | $8K |
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 | 307 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 227 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 15 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 549 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HIGHMARK WESTERN AND NORTHEASTERN NEW YORK, INC. | 518 | $4.8M |
| Dental | DELTA DENTAL OF NEW YORK | 619 | $190K |
| Vision | VISION SERVICE PLAN | 276 | $58K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 543 | $501K |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 543 | $501K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 543 | $501K |
| Prescription drug | HIGHMARK WESTERN AND NORTHEASTERN NEW YORK, INC. | 518 | $4.8M |
| Other(3 contracts, 3 carriers) | HIGHMARK WESTERN AND NORTHEASTERN NEW YORK, INC. | 543 | $5.3M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 619 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.