| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| UNKNOWN3 | UNKNOWN LINCOLN, NE 68504 | BLUECROSS BLUESHIELD OF NEBRASKA | $0 | $33K | $33K | 1.04% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | 40 EAST ALAMAR AVENUE SANTA BARBARA, CA 93105 | AMERITAS LIFE INSURANCE CORP. | $0 | $4K | $4K | 2.88% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL GREAT PLAINS, LLC | PO BOX 542006 OMAHA, NE 68154 | AMERITAS LIFE INSURANCE CORP. | $2K | $0 | $2K | 1.63% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL GREAT PLAINS, LLC | 11516 MIRACLE HILLS DRIVE SUITE 100 OMAHA, NE 68154 | SUN LIFE ASSURANCE COMPANY OF CANADA | $5K | $0 | $5K | 9.99% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL GREAT PLAINS, LLC | UNKNOWN LINCOLN, NE 68504 | ASSURITY LIFE INSURANCE COMPANY | $7K | $0 | $7K | 28.17% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL GREAT PLAINS, LLC | 11516 MIRACLE HILLS DRIVE SUITE 100 OMAHA, NE 68154 | METROPOLITAN LIFE INSURANCE COMPANY | $1K | $66 | $1K | 10.45% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL GREAT PLAINS, LLC | 11516 MIRACLE HILLS DRIVE SUITE 100 OMAHA, NE 68154 | HARTFORD LIFE AND ACCIDENT | $181 | $36 | $217 | 17.99% |
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 | 381 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 10 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 391 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUESHIELD OF NEBRASKA | 405 | $3.2M |
| Dental | AMERITAS LIFE INSURANCE CORP. | 457 | $152K |
| Vision | AMERITAS LIFE INSURANCE CORP. | 457 | $152K |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 381 | $52K |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 231 | $14K |
| Prescription drug | BLUECROSS BLUESHIELD OF NEBRASKA | 405 | $3.2M |
| Other(3 contracts, 3 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 381 | $79K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 457 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.