| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | 5314 SOUTH YALE AVENUE, SUITE 900 TULSA, OK 74135 | SUN LIFE ASSURANCE COMPANY OF CANADA | $20K | $0 | $20K | 10.00% |
| MGIS3 | 111 SOUTH MAIN STREET, SUITE 400 SALT LAKE CITY, UT 84111 | SUN LIFE ASSURANCE COMPANY OF CANADA | $0 | $180 | $180 | 0.09% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS, INC. | 6100 SOUTH YALE AVENUE, SUITE 1900 TULSA, OK 74136 | BLUECROSS BLUESHIELD OF OKLAHOMA | $7K | $6K | $13K | 10.50% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 5314 SOUTH YALE AVENUE, SUITE 900 TULSA, OK 74135 | BLUECROSS BLUESHIELD OF OKLAHOMA | $5K | $0 | $5K | 4.11% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS, INC. | 6100 SOUTH YALE AVENUE, SUITE 1900 TULSA, OK 74136 | AMERITAS LIFE INSURANCE CORPORATION | $502 | $0 | $502 | 5.21% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 5314 SOUTH YALE AVENUE, SUITE 900 TULSA, OK 74135 | AMERITAS LIFE INSURANCE CORPORATION | $462 | $0 | $462 | 4.79% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS, INC. | 40 EAST ALAMAR AVENUE SANTA BARBARA, CA 93105 | AMERITAS LIFE INSURANCE CORPORATION | $0 | $213 | $213 | 2.21% |
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 | 120 | 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) | 120 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | BLUECROSS BLUESHIELD OF OKLAHOMA | 254 | $127K |
| Vision | AMERITAS LIFE INSURANCE CORPORATION | 110 | $10K |
| Life insurance(2 contracts, 2 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 120 | $251K |
| Short-term disability | AMERICAN FIDELITY ASSURANCE COMPANY | 23 | $51K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 120 | $201K |
| Other(2 contracts, 2 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 120 | $251K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 254 | — |
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.