| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUBBARD BERT KARLE WEBER3 Filed as: HUBBARD BERT KARLE WEBER INC. | 1250 TOWER LANE ERIE, PA 16505 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $22K | — | $22K | 5.00% |
| EXPRESSLINK GENERAL AGENCY LLC3 Filed as: EXPRESSLINK GENERAL AGENCY | 4200 ROCKSIDE RD STE 103 CLEVELAND, OH 441312530 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $18K | $18K | 4.02% |
| HUBBARD BERT KARLE WEBER3 | 1250 TOWER LANE ERIE, PA 16505 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $19K | — | $19K | 5.00% |
| EXPRESSLINK GENERAL AGENCY LLC3 Filed as: EXPRESSLINK GENERAL AGENCY | 4200 ROCKSIDE RD STE 103 CLEVELAND, OH 441312530 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $18K | $18K | 4.58% |
| HUBBARD BERT KARLE WEBER3 | 1250 TOWER LANE ERIE, PA 16505 | HIGHMARK CASUALTY INS CO | $25K | — | $25K | 8.04% |
| EXPRESSLINK GENERAL AGENCY LLC3 Filed as: EXPRESSLINK GENERAL AGENCY | 4200 ROCKSIDE RD STE 103 CLEVELAND, OH 441312530 | UNITED OF OMAHA LIFE INSURANCE COMAPNY | — | $9K | $9K | 6.85% |
| HUBBARD BERT KARLE WEBER3 Filed as: HUBBARD BERT KARLE WEBER, INC. | 1250 TOWER LANE ERIE, PA 16505 | UNITED OF OMAHA LIFE INSURANCE COMAPNY | $6K | — | $6K | 5.00% |
| HUBBARD BERT KARLE WEBER3 Filed as: HUBBARD BERT KARLE WEBER, INC. | 1250 TOWER LANE ERIE, PA 16505 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $211 | — | $211 | 15.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HIGHMARK EIN 23-1294723 NONE | Claims processing Service code 12 | — | $779K |
| HBKW, INC. EIN 25-1185026 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.); Direct payment from the plan; Claims processing Service code 12 | — | $44K |
| HUBBARD BERT KARLE WEBER, INC. EIN 25-1185026 NONE | Contract Administrator Service code 13 | — | $0 |
| MEDCO HEALTH SOLUTIONS EIN 22-3461740 NONE | Claims processing Service code 12 | — | $0 |
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 | 1,669 | 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) | 1,669 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 1,574 | $435K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMAPNY | 721 | $127K |
| Stop-loss / reinsurancereinsurance | HIGHMARK CASUALTY INS CO | 1,647 | $307K |
| Other(3 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 1,574 | $819K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,647 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.