| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 5314 S YALE AVE STE 900 TULSA, OK 74135 | COMMUNITY CARE | $3K | — | $3K | 0.77% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | PO BOX 844501 DALLAS, TX 75284 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $131 | $2K | 11.18% |
| WILLIAM D STAEDKE0 | 25695 W 71ST S BROKEN ARROW, OK 74014 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $766 | $193 | $959 | 6.45% |
| MARILYN K EMBERSON0 | 7220 N HAMMOND AVE OKLAHOMA CITY, OK 73132 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $552 | $55 | $607 | 4.08% |
| KELLY W PUGH0 | 7367 S 286TH E AVE BROKEN ARROW, OK 74014 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $271 | $92 | $363 | 2.44% |
| SHANNON MARIE BALDWIN0 | 10222 E 114TH ST S BIXBY, OK 74008 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $307 | $23 | $330 | 2.22% |
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 | 211 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 211 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | COMMUNITY CARE | 211 | $435K |
| Dental | DELTA DENTAL | 106 | $57K |
| Life insurance(2 contracts, 2 carriers) | UNUM LIFE | 132 | $12K |
| Short-term disability | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 23 | $15K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 211 | — |
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.