| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MID-AMERICA | 6100 S. YALE AVE., SUITE 1900 TULSA, OK 74136 | BLUE CROSS AND BLUE SHIELD OF KANSAS | $48K | — | $48K | 2.90% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST | 7331 W 33RD N, SUITE 100 WICHITA, KS 67205 | HARTFORD LIFE INSURANCE COMPANY | $27K | — | $27K | 17.15% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST | 1591 GALBRAITH AVE SE GRAND RAPIDS, MI 49546 | HARTFORD LIFE INSURANCE COMPANY | — | $6K | $6K | 3.78% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: GBS A DIVISION OF HUB INTERNATIONAL | 6100 SOUTH YALE AVE., SUITE 900 TULSA, OK 74136 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $6K | $374 | $7K | 18.54% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 8110 E 32ND ST. N., SUITE 100 WICHITA, KS 67226 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $16 | — | $16 | 0.04% |
| PLANSOURCE BENEFIT ADMINISTRATION3 | P.O. BOX 1313 ORLANDO, FL 32802 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3 | — | $3 | 0.01% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: GBS HUB INTERNATIONAL | 6100 S. YALE AVE., SUITE 1900 TULSA, OK 741361947 | SURENCY LIFE AND HEALTH | $2K | — | $2K | 6.98% |
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 | 214 | 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) | 214 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS AND BLUE SHIELD OF KANSAS | 308 | $1.7M |
| Dental | BLUE CROSS AND BLUE SHIELD OF KANSAS | 308 | $1.7M |
| Vision | SURENCY LIFE AND HEALTH | 156 | $26K |
| Life insurance | HARTFORD LIFE INSURANCE COMPANY | 223 | $157K |
| Short-term disability(2 contracts, 2 carriers) | HARTFORD LIFE INSURANCE COMPANY | 223 | $193K |
| Long-term disability | HARTFORD LIFE INSURANCE COMPANY | 223 | $157K |
| Prescription drug | BLUE CROSS AND BLUE SHIELD OF KANSAS | 308 | $1.7M |
| Other(2 contracts, 2 carriers) | HARTFORD LIFE INSURANCE COMPANY | 223 | $193K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 308 | — |
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.