| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CLIFF PENDEN0 | 713 GLENRIDGE DR EDMOND, OK 73013 | UNIFIED LIFE INSURANCE COMPANY | $800 | — | $800 | 0.79% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST | 5314 S YALE AVENUE SUITE 900 TULSA, OK 74135 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $6K | — | $6K | 10.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST | 5314 SOUTH YALE SUITE 900 TULSA, OK 74135 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $4K | — | $4K | 10.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UNITED HEALTHCARE SERVICES INC EIN 41-1289245 CLAIMS PROCESSOR | Claims processing; Other services Service code 12 | 22561 NETWORK PLACE CHICAGO, IL 60673 | $242K |
| PEDEN EMPLOYEE BENEFITS EIN 73-1622731 CONSULTANT | Consulting (general) Service code 16 | 713 GLENRIDGE DRIVE EDMOND, OK 73013 | $14K |
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 | 378 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 378 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | UNITED HEALTHCARE INSURANCE COMPANY | 770 | $617K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 222 | $36K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 235 | $58K |
| Stop-loss / reinsurancereinsurance | UNITED HEALTHCARE INSURANCE COMPANY | 770 | $517K |
| Other | CIGNA LIFE INSURANCE COMPANY OF NEW YORK | 15 | $1K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 770 | — |
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."
No prospect flags tripped on this filing.