| 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 | $18K | — | $18K | 12.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL TEXAS, INC. | 3221 COLLINSWORTH ST FORT WORTH, TX 76107 | METROPOLITAN LIFE INSURANCE COMPANY | $7K | $3K | $10K | 11.94% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL TEXAS INC | 601 N MESA ST STE 1550 EL PASO, TX 79901 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $11K | $3K | $15K | 25.99% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL TEXAS INC. | 601 N MESA ST STE 1550 EL PASO, TX 79901 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $9K | $3K | $11K | 25.86% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL TEXAS, INC. | 425 ASHLEY RIDGE BLVD, STE 230 SHREVEPORT, LA 71106 | CRUM & FORSTER | $471 | — | $471 | 11.99% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| FRINGE BENEFIT GROUP, INC. EIN 74-2124394 ADMIN | Plan Administrator Service code 14 | — | $27K |
| HUB INTERNATIONAL TEXAS, INC. (LA) EIN 75-1473193 BROKER FEE | Insurance agents and brokers Service code 22 | — | $8K |
| MULTIPLAN, INC EIN 13-3068979 PPO FEE | Other fees Service code 99 | — | $5K |
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 | 226 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 227 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 217 | $80K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 217 | $80K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 79 | $44K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 89 | $57K |
| Stop-loss / reinsurancereinsurance | NATIONWIDE | 172 | $6K |
| Other(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 172 | $48K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 217 | — |
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.