| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HOLMES MURPHY & ASSOCIATES3 Filed as: HOLMES MURPHY & ASSOCIATES INC | — | AETNA HEALTH, INC. | $21K | — | $21K | 4.92% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BLACK GOULD AND ASSOCIATES | 3800 N CENTRAL AVE 9TH FLOOR PHOENIX, AZ 85012 | AETNA HEALTH, INC. | $4K | — | $4K | 0.85% |
| 12712 PARK CENTRAL DRIVE3 | STE 100 DALLAS, TX 752511527 | AMERITAS LIFE INSURANCE CORP. | $2K | — | $2K | 3.81% |
| HOLMES MURPHY & ASSOCIATES3 Filed as: HOLMES MURPHY & ASSOCIATES INC | 2637 S 158TH PLAZA STE 200 OMAHA, NE 681301769 | AMERITAS LIFE INSURANCE CORP. | — | $1K | $1K | 1.89% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BLACK GOULD INSURANCE SERVICES | 3800 N CENTRAL AVE FLOOR 9 PHOENIX, AZ 850121979 | AMERITAS LIFE INSURANCE CORP. | $435 | — | $435 | 0.74% |
| HOLMES MURPHY & ASSOCIATES3 Filed as: HOLMES MURPHY & ASSOCIATES INC | — | AETNA LIFE INSURANCE CO. | $2K | — | $2K | 4.86% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BLACK GOULD AND ASSOCIATES | 3800 N CENTRAL AVE 9TH FLOOR PHOENIX, AZ 85012 | AETNA LIFE INSURANCE CO. | $363 | — | $363 | 0.95% |
| HOLMES MURPHY & ASSOCIATES3 Filed as: HOLMES MURPHY AND ASSOCIATES INC | P.O. BOX 9207 DES MOINES, IA 503069207 | STANDARD INSURANCE COMPANY | $3K | $365 | $3K | 11.06% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BLACK GOULD & ASSOCIATES | 3800 N CENTRAL AVENUE 9TH FLOOR PHOENIX, AZ 85012 | STANDARD INSURANCE COMPANY | $2K | — | $2K | 6.81% |
| HOLMES MURPHY & ASSOCIATES3 Filed as: HOLMES MURPHY AND ASSOCIATES INC | — | STANDARD INSURANCE COMPANY | $294 | $35 | $329 | 11.25% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BLACK GOULD & ASSOCIATES | 3800 N CENTRAL AVENUE 9TH FLOOR PHOENIX, AZ 85012 | STANDARD INSURANCE COMPANY | $191 | — | $191 | 6.53% |
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 | 151 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 151 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | AETNA LIFE INSURANCE CO. | 9 | $38K |
| Dental | AMERITAS LIFE INSURANCE CORP. | 96 | $59K |
| Vision | AMERITAS LIFE INSURANCE CORP. | 96 | $59K |
| Life insurance | STANDARD INSURANCE COMPANY | 151 | $3K |
| Short-term disability | STANDARD INSURANCE COMPANY | 151 | $31K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 151 | — |
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.