| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: GBS/HUB INTERNATIONAL MIDWEST | PO BOX 47567 WICHITA, KS 67201 | DELTA DENTAL OF KANSAS, INC. | $6K | — | $6K | 7.98% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: GBS A DIVISION OF HUB INTERNAT | PO BOX 844501 DALLAS, TX 752844501 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $716 | $57 | $773 | 10.80% |
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 | 224 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 224 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF KANSAS, INC. | 224 | $77K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 214 | $7K |
| Stop-loss / reinsurancereinsurance | STANDARD SECURITY LIFE INSURANCE | 221 | $295K |
| Other | UNUM LIFE INSURANCE COMPANY OF AMERICA | 214 | $7K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 224 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.