| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | 421 WEST 3RD, SUITE 800 FORT WORTH, TX 76102 | UNITEDHEALTHCARE INSURANCE COMPANY | $16K | — | $16K | 4.46% |
| WM RIGG CO3 Filed as: WM RIGG COMPANY | PO BOX 847746 DALLAS, TX 75284 | UNITEDHEALTHCARE INSURANCE COMPANY | — | $2K | $2K | 0.48% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | 700 NORTH PEARL STREET, SUITE N1700 DALLAS, TX 75201 | STARMOUNT LIFE INSURANCE COMPANY | $13K | — | $13K | 10.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | 421 WEST 3RD STREET, SUITE 800 FORT WORTH, TX 76102 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $17K | $5K | $22K | 19.05% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | 700 NORTH PEARL STREET, SUITE N1700 DALLAS, TX 75201 | COMBINED INSURANCE COMPANY OF AMERICA | $9K | — | $9K | 28.34% |
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 | 307 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 310 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITEDHEALTHCARE INSURANCE COMPANY | 57 | $354K |
| Dental | STARMOUNT LIFE INSURANCE COMPANY | 301 | $130K |
| Vision | STARMOUNT LIFE INSURANCE COMPANY | 301 | $130K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 188 | $116K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 188 | $116K |
| Prescription drug | UNITEDHEALTHCARE INSURANCE COMPANY | 57 | $354K |
| Other(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 307 | $147K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 307 | — |
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.