| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST LTD | 2118 NORTH TYLER, BUILDING C WICHITA, KS 67212 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $19K | $19K | $38K | 4.48% |
| PLANSOURCE BENEFITS ADMINISTRATION3 | PO BOX 1313 ORLANDO, FL 32802 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $24K | $0 | $24K | 2.81% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 16253 COLLECTION CENTER DRIVE 40 WEST MADISON, 4TH FLOOR CHICAGO, IL 60693 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $1K | $1K | 0.78% |
| PLANSOURCE BENEFITS ADMINISTRATION3 | 101 SOUTH GARLAND AVENUE, SUITE 203 ORLANDO, FL 32801 | METROPOLITAN LIFE INSURANCE COMPANY | $913 | $0 | $913 | 0.62% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 6100 SOUTH YALE AVENUE, SUITE 1900 TULSA, OK 74136 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $132 | $132 | 0.09% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST LTD | 2118 NORTH TYLER, BUILDING C WICHITA, KS 67212 | UNUM INSURANCE COMPANY | $14K | $3K | $16K | 16.60% |
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 | 1,160 | 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) | 1,160 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN INC | 131 | $926K |
| Dental | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY | 786 | $917K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 1,565 | $147K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,160 | $847K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,160 | $847K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC | 131 | $926K |
| Other(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,160 | $946K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,565 | — |
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.