| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MID AMERICA | 6100 S YALE AVE STE 1900 TULSA, OK 74136 | BLUE CROSS AND BLUE SHIELD OF KANSAS | $69K | — | $69K | 2.40% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: GBS/HUB INTERNATIONAL MIDWEST | 9200 WARD PKWY STE 500 KANSAS CITY, MO 64114 | DELTA DENTAL OF KANSAS INC | $14K | — | $14K | 7.49% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 9200 WARD PKWY STE 500 KANSAS CITY, MO 64114 | STANDARD INSURANCE COMPANY | $6K | — | $6K | 6.28% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 6100 S YALE AVE STE 1900 TULSA, OK 74136 | STANDARD INSURANCE COMPANY | $4K | — | $4K | 3.82% |
| PAYCOM PAYROLL LLC3 Filed as: PAYCOM PAYROLL HOLDINGS LLC | 7501 W MEMORIAL RD OKLAHOMA CITY, OK 73142 | STANDARD INSURANCE COMPANY | — | $3K | $3K | 3.14% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: GBS HUB INTERNATIONAL MIDWEST | 7331 W 33RD ST NORTH SUITE 100 WICHITA, KS 67205 | SURENCY LIFE AND HEALTH | $4K | — | $4K | 9.86% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 6100 S YALE AVE STE 1900 TULSA, OK 74136 | STANDARD INSURANCE COMPANY | $2K | — | $2K | 6.30% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 9200 WARD PKWY STE 500 KANSAS CITY, MO 64114 | STANDARD INSURANCE COMPANY | $2K | — | $2K | 6.00% |
| PAYCOM PAYROLL LLC3 Filed as: PAYCOM PAYROLL HOLDINGS LLC | 7501 W MEMORIAL RD OKLAHOMA CITY, OK 73142 | STANDARD INSURANCE COMPANY | — | $1K | $1K | 3.15% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 6100 S YALE AVE STE 1900 TULSA, OK 74136 | STANDARD INSURANCE COMPANY | $19K | — | $19K | 67.07% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 9200 WARD PKWY STE 500 KANSAS CITY, MO 64114 | STANDARD INSURANCE COMPANY | $2K | — | $2K | 7.66% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 6100 S YALE AVE STE 1900 TULSA, OK 74136 | STANDARD INSURANCE COMPANY | $3K | — | $3K | 12.12% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 9200 WARD PKWY STE 500 KANSAS CITY, MO 64114 | STANDARD INSURANCE COMPANY | $1K | — | $1K | 5.42% |
| PAYCOM PAYROLL LLC3 Filed as: PAYCOM PAYROLL HOLDINGS LLC | 7501 W MEMORIAL RD OKLAHOMA CITY, OK 73142 | STANDARD INSURANCE COMPANY | — | $713 | $713 | 3.10% |
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 | 442 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 446 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS AND BLUE SHIELD OF KANSAS | 449 | $2.9M |
| Dental | DELTA DENTAL OF KANSAS INC | 303 | $183K |
| Vision | SURENCY LIFE AND HEALTH | 224 | $44K |
| Life insurance | STANDARD INSURANCE COMPANY | 442 | $99K |
| Short-term disability | STANDARD INSURANCE COMPANY | 133 | $37K |
| Long-term disability | STANDARD INSURANCE COMPANY | 64 | $23K |
| Prescription drug | BLUE CROSS AND BLUE SHIELD OF KANSAS | 449 | $2.9M |
| Other(3 contracts, 2 carriers) | STANDARD INSURANCE COMPANY | 488 | $138K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 488 | — |
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.