| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE | SERVICES INC 200 S COLORAD BLVD STE 150 DENVER, CO 80222 | UNITEDHEALTHCARE INSURANCE COMPANY | $41K | — | $41K | 1.16% |
| CHERRY CREEK BENEFITS3 Filed as: CHERRY CREEK INSURANCE AGENCY, INC. | 155 INVERNESS DR W ENGLEWOOD, CO 80112 | UNITEDHEALTHCARE INSURANCE COMPANY | $14K | — | $14K | 0.41% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SERVICE INC | 1125 17TH ST STE 900 DENVER, CO 80202 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $7K | $3K | $9K | 14.68% |
| PAYCOM PAYROLL LLC5 | 7501 W MEMORIAL RD OKLAHOMA CITY, OK 73142 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $4K | $4K | 5.75% |
| CHERRY CREEK BENEFITS3 Filed as: CHERRY CREEK INSURANCE AGENCY INC | 5660 GREENWOOD PLAZA BLVD STE 500 GREENWOOD VILLAGE, CO 80111 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | — | $3K | 4.83% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SERVICE INC | 1125 17TH ST STE 900 DENVER, CO 80202 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $3K | $7K | 10.86% |
| PAYCOM PAYROLL LLC5 | 7501 W MEMORIAL RD OKLAHOMA CITY, OK 73142 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $4K | $4K | 5.81% |
| CHERRY CREEK BENEFITS3 Filed as: CHERRY CREEK INSURANCE AGENCY INC | 5660 GREENWOOD PLAZA BLVD STE 500 GREENWOOD VILLAGE, CO 80111 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 3.89% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SERVICE INC | 1125 17TH ST STE 900 DENVER, CO 80202 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $6K | $4K | $10K | 16.99% |
| CHERRY CREEK BENEFITS3 Filed as: CHERRY CREEK INSURANCE AGENCY INC | 5660 GREENWOOD PLAZA BLVD STE 500 GREENWOOD VILLAGE, CO 80111 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | — | $4K | 6.83% |
| PAYCOM PAYROLL LLC5 | 7501 W MEMORIAL RD OKLAHOMA CITY, OK 73142 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $4K | $4K | 6.37% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE | SERVICES INC. 1125 17TH ST SUITE 900 DENVER, CO 80222 | CONTINENTAL AMERICAN INSURANCE COMPANY | $11K | — | $11K | 21.23% |
| CHERRY CREEK BENEFITS3 Filed as: CHERRY CREEK INSURANCE AGENCY, INC. | 155 INVERNESS DRIVE WEST ENGLEWOOD, CO 80112 | CONTINENTAL AMERICAN INSURANCE COMPANY | $3K | — | $3K | 6.66% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 2000 S. COLORADO BLVD TOWER 2, SUITE #150 DENVER, CO 80222 | CONTINENTAL AMERICAN INSURANCE COMPANY | $2K | — | $2K | 4.40% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE | SERVICES INC. 1125 17TH ST SUITE 900 DENVER, CO 80222 | CONTINENTAL AMERICAN INSURANCE COMPANY | $898 | — | $898 | 1.72% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SERVICE INC | 1125 17TH ST STE 900 DENVER, CO 80202 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $3K | $6K | 12.27% |
| PAYCOM PAYROLL LLC5 | 7501 W MEMORIAL RD OKLAHOMA CITY, OK 73142 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $4K | $4K | 8.21% |
| CHERRY CREEK BENEFITS3 Filed as: CHERRY CREEK INSURANCE AGENCY INC | 5660 GREENWOOD PLAZA BLVD STE 500 GREENWOOD VILLAGE, CO 80111 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $865 | — | $865 | 1.91% |
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 | 443 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 444 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | UNITEDHEALTHCARE INSURANCE COMPANY | 750 | $3.6M |
| Dental | UNITEDHEALTHCARE INSURANCE COMPANY | 750 | $3.5M |
| Vision | UNITEDHEALTHCARE INSURANCE COMPANY | 750 | $3.5M |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 443 | $104K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 197 | $65K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 183 | $64K |
| Other(5 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 443 | $284K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 750 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.