| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 | UNKNOWN CHICAGO, IL 60604 | AETNA LIFE INSURANCE COMPANY | $20K | $11K | $31K | 1.01% |
| HOLLABAUGH, MARC, ALAN3 | 836 WEST 62ND STREET KANSAS CITY, MO 64113 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $55K | $4K | $59K | 16.80% |
| JOHNSON KEITH W3 Filed as: JOHNSON, KEVIN, R | 7500 COLLEGE BOULEVARD, SUITE 150 OVERLAND PARK, KS 66210 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $24K | $0 | $24K | 6.91% |
| NYLIFE SECURITIES LLC3 | 51 MADISON AVENUE NEW YORK, NY 10010 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $0 | $2K | $2K | 0.49% |
| MULLINIX, JAMES, P3 | 580 LAKESHORE DRIVE WEST LAKE QUIVIRA, KS 66217 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $0 | $1K | 0.34% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MID-AMERICA | 425 WEST CAPITOL AVENUE, SUITE 3550 LITTLE ROCK, AR 72201 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $12K | $3K | $14K | 16.09% |
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 | 327 | 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) | 327 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | AETNA LIFE INSURANCE COMPANY | 563 | $3.1M |
| Dental | AETNA LIFE INSURANCE COMPANY | 563 | $3.1M |
| Vision | AETNA LIFE INSURANCE COMPANY | 563 | $3.1M |
| Life insurance(2 contracts, 2 carriers) | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 977 | $439K |
| Short-term disability(2 contracts, 2 carriers) | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 977 | $439K |
| Prescription drug | AETNA LIFE INSURANCE COMPANY | 563 | $3.1M |
| Other(3 contracts, 3 carriers) | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 977 | $439K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 977 | — |
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.