| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 | UNKNOWN BALDWIN, KS 66006 | BLUE CROSS BLUE SHIELD OF KANSAS CITY | $92K | $0 | $92K | 2.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 6100 SOUTH YALE AVENUE, SUITE 1900 TULSA, OK 74136 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $31K | $16K | $46K | 12.12% |
| PAYCOM PAYROLL LLC5 | 7501 WEST MEMORIAL ROAD OKLAHOMA CITY, OK 73142 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $11K | $11K | 2.76% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL LIMITED | UNKNOWN BALDWIN, KS 66006 | DELTA DENTAL OF KANSAS, INC. | $21K | $0 | $21K | 8.49% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 9200 WARD PARKWAY, SUITE 500 KANSAS CITY, MO 64114 | VISION SERVICE PLAN | $2K | $0 | $2K | 3.78% |
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 | 532 | 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) | 532 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF KANSAS CITY | 662 | $4.6M |
| Dental | DELTA DENTAL OF KANSAS, INC. | 374 | $251K |
| Vision | VISION SERVICE PLAN | 336 | $49K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 532 | $383K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 532 | $383K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 532 | $383K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF KANSAS CITY | 662 | $4.6M |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 532 | $383K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 662 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.