| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | 5314 SOUTH YALE AVENUE SUITE 900 TULSA, OK 74135 | UNITEDHEALTHCARE INSURANCE COMPANY | $0 | $53K | $53K | 4.99% |
| ROGERS BENEFIT GROUP INC3 Filed as: ROGERS BENEFIT GROUP INC-OKLAHOMA | 5110 NORTH 40TH STREET SUITE 234 PHOENIX, AZ 85018 | UNITEDHEALTHCARE INSURANCE COMPANY | $11K | $0 | $11K | 1.02% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | 6100 SOUTH YALE AVENUE, SUITE 1900 TULSEA, OK 74136 | METROPOLITAN LIFE INSURANCE COMPANY | $13K | $0 | $13K | 8.44% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | 16253 COLLECTION CENTER DRIVE 40 WEST MADISON 4TH FLOOR CHICAGO, IL 60693 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $3K | $3K | 1.73% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | 6100 SOUTH YALE AVENUE SUITE 1900 TULSA, OK 74132 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $10K | $2K | $13K | 17.54% |
| WILLIAM D STAEDKE3 | PO BOX 140803 BROKEN ARROW, OK 74014 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $8K | $4K | $12K | 16.56% |
| KELLY W PUGH3 | 7367 SOUTH 286TH EAST AVENUE BROKEN ARROW, OK 74014 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $646 | $3K | 3.67% |
| SHANNON MARIE BALDWIN3 | 10222 EAST 114TH STREET SOUTH BIXBY, OK 74008 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $333 | $2K | 3.44% |
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 | 100 | 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) | 100 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITEDHEALTHCARE INSURANCE COMPANY | 213 | $1.1M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 273 | $150K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 273 | $150K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 273 | $150K |
| Short-term disability | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 92 | $72K |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 273 | $150K |
| Prescription drug | UNITEDHEALTHCARE INSURANCE COMPANY | 213 | $1.1M |
| Other(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 273 | $222K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 273 | — |
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.