| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 | 6100 SOUTH YALE AVENUE, SUITE 1900 TULSA, OK 74136 | BLUECROSS BLUESHIELD OF OKLAHOMA | $23K | $2K | $25K | 1.72% |
| USI INSURANCE SERVICES LLC3 | 14241 DALLAS PARKWAY, SUITE 700 DALLAS, TX 75254 | BLUECROSS BLUESHIELD OF OKLAHOMA | $21K | $3 | $21K | 1.45% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 6100 SOUTH YALE AVENUE, SUITE 1900 TULSA, OK 74136 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $13K | $0 | $13K | 7.84% |
| USI INSURANCE SERVICES LLC3 | PO BOX 61187 VIRGINIA BEACH, VA 23466 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $12K | $0 | $12K | 7.16% |
| ADP INC5 Filed as: AUTOMATIC DATA PROCESSING, INC. | PO BOX 842875 BOSTON, MA 02284 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $5K | $5K | 3.10% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 6100 SOUTH YALE AVENUE, SUITE 1900 TULSA, OK 74136 | DELTA DENTAL OF OKLAHOMA | $4K | $0 | $4K | 4.22% |
| USI INSURANCE SERVICES LLC3 | 9811 KATY FREEWAY, SUITE 500 HOUSTON, TX 77024 | DELTA DENTAL OF OKLAHOMA | $3K | $0 | $3K | 3.78% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 6100 SOUTH YALE AVENUE, SUITE 1900 TULSA, OK 74136 | VISION SERVICE PLAN | $668 | $0 | $668 | 4.19% |
| USI INSURANCE SERVICES LLC3 | PO BOX 61187 VIRGINIA BEACH, VA 23466 | VISION SERVICE PLAN | $294 | $0 | $294 | 1.84% |
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 | 176 | 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) | 176 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUESHIELD OF OKLAHOMA | 194 | $1.5M |
| Dental | DELTA DENTAL OF OKLAHOMA | 140 | $87K |
| Vision | VISION SERVICE PLAN | 140 | $16K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 214 | $161K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 214 | $161K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 214 | $161K |
| Prescription drug | BLUECROSS BLUESHIELD OF OKLAHOMA | 194 | $1.5M |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 214 | $161K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 214 | — |
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.