| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PLANSOURCE BENEFITS ADMINISTRATION3 | PO BOX 1313 ORLANDO, FL 32802 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $26K | $0 | $26K | 2.63% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST | 6100 SOUTH YALE AVENUE, SUITE 1900 TULSA, FL 74136 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $21K | $4K | $25K | 2.49% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST LTD | 6100 SOUTH YALE AVENUE, SUITE 1900 TULSA, OK 74136 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $13K | $13K | 1.33% |
| PLANSOURCE BENEFITS ADMINISTRATION3 Filed as: PLANSOURCE BENEFITS ADMIN., INC. | PO BOX 1313 ORLANDO, FL 32802 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4K | $0 | $4K | 0.38% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 16253 COLLECTION CENTER DRIVE CHICAGO, IL 60693 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $2K | $2K | 1.49% |
| PLANSOURCE BENEFITS ADMINISTRATION3 Filed as: PLANSOURCE BENEFITS ADMIN., INC. | 101 SOUTH GARLAND AVENUE SUITE 203 ORLANDO, FL 32801 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $512 | $512 | 0.37% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 6100 SOUTH YALE AVENUE, SUITE 1900 TULSA, OK 74136 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $118 | $118 | 0.09% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST LTD | 6100 SOUTH YALE AVENUE, SUITE 1900 TULSA, OK 74136 | UNUM INSURANCE COMPANY | $11K | $1K | $13K | 16.88% |
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 | 783 | 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) | 783 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts) | KAISER FOUNDATION HEALTH PLAN INC | 104 | $1.0M |
| Dental | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY | 691 | $849K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 1,399 | $138K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,037 | $1.0M |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,037 | $1.0M |
| Prescription drug(2 contracts) | KAISER FOUNDATION HEALTH PLAN INC | 104 | $1.0M |
| Other(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,037 | $1.1M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,399 | — |
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.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.