| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL TEXAS INC. | 700 NORTH PEARL STREET, SUITE N1700 DALLAS, TX 75201 | UNITEDHEALTHCARE INSURANCE COMPANY | $15K | $64K | $79K | 5.44% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 1411 OPUS PLACE, SUITE 450 DOWNERS GROVE, IL 60515 | UNITEDHEALTHCARE INSURANCE COMPANY | $0 | $2K | $2K | 0.14% |
| J. MICHAEL BLACK3 | PO BOX 1866 CENTER, TX 75935 | UNITEDHEALTHCARE INSURANCE COMPANY | -$6 | $72 | $66 | 0.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL TEXAS INC. | 700 NORTH PEARL STREET, SUITE N1700 DALLAS, TX 75201 | UNITEDHEALTHCARE INSURANCE COMPANY | $5K | $26K | $31K | 5.77% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL TEXAS INC. | 10000 NORTH CENTRAL EXPRESSWAY SUITE 1200 DALLAS, TX 75231 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $18K | $4K | $22K | 18.56% |
| FMLASOURCE INC5 | 455 NORTH CITYFRONT PLAZA DRIVE 13TH FLOOR CHICAGO, IL 60611 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $6K | $6K | 5.30% |
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 | 229 | 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) | 229 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts) | UNITEDHEALTHCARE INSURANCE COMPANY | 681 | $2.0M |
| Dental(2 contracts) | UNITEDHEALTHCARE INSURANCE COMPANY | 681 | $2.0M |
| Vision(2 contracts) | UNITEDHEALTHCARE INSURANCE COMPANY | 681 | $2.0M |
| Life insurance(2 contracts) | UNITEDHEALTHCARE INSURANCE COMPANY | 681 | $2.0M |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 345 | $117K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 345 | $117K |
| Prescription drug(2 contracts) | UNITEDHEALTHCARE INSURANCE COMPANY | 681 | $2.0M |
| Other(2 contracts) | UNITEDHEALTHCARE INSURANCE COMPANY | 681 | $2.0M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 681 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.