| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL GREAT PLAINS, LLC | 11516 MIRACLE HILLS DR STE 100 OMAHA, NE 68154 | SUNLIFE - STOP LOSS | — | $6K | $6K | 2.54% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL GREAT PLAINS, LLC | 11516 MIRACLE HILLS DR STE 100 OMAHA, NE 68154 | HARTFORD LIFE AND ACCIDENT | $4K | — | $4K | 10.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTL MIDWEST LIMITED | 2120 PEWAUKEE ROAD SUITE 202 WAUKESHA, WI 53188 | HARTFORD LIFE AND ACCIDENT | — | $999 | $999 | 2.74% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UMR, INC. EIN 39-1995276 NONE | Claims processing Service code 12 | — | $52K |
| SILVERSTONE GROUP INCORPORATION | Insurance brokerage commissions and fees Service code 53 | — | $23K |
| FORVIS, LLP EIN 44-0160260 NONE | Accounting (including auditing) Service code 10 | — | $17K |
| THERESA FLOWERS EIN 47-6062771 RELATED PLAN EE | Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $15K |
| CELESTE GARDNER EIN 47-6062771 RELATED PLAN EE | Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $5K |
| WEINBERG & WEINBERG EIN 47-0561017 NONE | Legal Service code 29 | — | $3K |
| SILVERSTONE GROUP INCORPORATED EIN 47-0813106 NONE | Insurance brokerage commissions and fees Service code 53 | — | $0 |
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 | 100 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 100 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | HARTFORD LIFE AND ACCIDENT | 91 | $36K |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 91 | $36K |
| Stop-loss / reinsurancereinsurance | SUNLIFE - STOP LOSS | 101 | $251K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 101 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.