| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL TEXAS, INC. | 425 ASHLEY RIDGE BLVD, STE 230 SHREVEPORT, LA 71106 | NATIONWIDE | $26K | — | $26K | 12.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL TEXAS, INC. | 3221 COLLINSWORTH ST FORT WORTH, TX 76107 | STARMOUNT LIFE INSURANCE COMPANY | $11K | $2K | $13K | 12.50% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL TEXAS INC | 10000 N CENTRAL EXPY STE 1200 DALLAS, TX 75231 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $14K | $6K | $20K | 27.71% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL TEXAS INC. | 10000 N CENTRAL EXPY STE 1200 DALLAS, TX 75231 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $10K | $4K | $15K | 28.24% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL TEXAS, INC. | 425 ASHLEY RIDGE BLVD, STE 230 SHREVEPORT, LA 71106 | CRUM & FORSTER | $634 | — | $634 | 12.00% |
| HUB INTERNATIONAL MIDWEST LIMITED Filed as: HUB INTERNATIONAL TEXAS, INC | — | CRUM & FORSTER | — | — | $0 | 0.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| FRINGE BENEFIT GROUP, INC. EIN 74-2124394 ADMIN | Plan Administrator Service code 14 | — | $33K |
| HUB INTERNATIONAL TEXAS, INC. (LA) EIN 75-1473193 BROKER FEE | Insurance agents and brokers Service code 22 | — | $10K |
| MULTIPLAN, INC EIN 13-3068979 PPO FEE | Other fees Service code 99 | — | $6K |
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 | 390 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 390 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | STARMOUNT LIFE INSURANCE COMPANY | 244 | $101K |
| Vision | STARMOUNT LIFE INSURANCE COMPANY | 244 | $101K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 106 | $51K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 113 | $71K |
| Stop-loss / reinsurancereinsurance | NATIONWIDE | 241 | $6K |
| Other(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 241 | $57K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 244 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.