| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 | 6100 S YALE AVE STE 1900 TULSA, OK 741361903 | UNITEDHEALTHCARE INSURANCE COMPANY | -$24 | $79K | $79K | 4.17% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 1411 OPUS STE 450 DOWNERS GROVE, IL 605151423 | UNITEDHEALTHCARE INSURANCE COMPANY | — | $10K | $10K | 0.51% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 6100 S YALE AVE STE 1900 TULSA, OK 741361903 | UNITEDHEALTHCARE INSURANCE COMPANY | — | $31K | $31K | 4.08% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST LTD | HUB INTERNATIONAL MID-AMERICA 2118 N TYLER BLDG C WICHITA, KS 67212 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $40K | $8K | $48K | 18.14% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 55 E JACKSON BLVD STE 12A CHICAGO, IL 60604 | DELTA DENTAL PLAN OF ARKANSAS | $26K | — | $26K | 10.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | HUB INTERNATIONAL MID-AMERICA 2118 N TYLER BLDG C WICHITA, KS 67212 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $21K | $5K | $26K | 18.40% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 55 E JACKSON BLVD STE 12A CHICAGO, IL 60604 | DELTA VISION PLAN OF ARKANSAS | $3K | — | $3K | 81.21% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UNITED HEALTHCARE SERVICES, INC. EIN 41-1289245 CONTRACT ADMINISTRATOR | Contract Administrator; Plan Administrator Service code 13 | — | $38K |
| KELLY ELKINS BROKER | Insurance agents and brokers; Other commissions Service code 22 | 6100 S YALE AVE STE 1900 TULSA, OK 741361903 | $5K |
| ALL SAVERS INSURANCE COMPANY EIN 35-1665915 CLAIMS PROCESSING | Claims processing Service code 12 | — | $4K |
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 | 445 | 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) | 445 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITEDHEALTHCARE INSURANCE COMPANY | 331 | $1.9M |
| Dental(2 contracts, 2 carriers) | UNITEDHEALTHCARE INSURANCE COMPANY | 733 | $2.1M |
| Vision(2 contracts, 2 carriers) | UNITEDHEALTHCARE INSURANCE COMPANY | 668 | $1.9M |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 452 | $143K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 340 | $264K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 340 | $264K |
| Other(2 contracts, 2 carriers) | UNITEDHEALTHCARE INSURANCE COMPANY | 452 | $910K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 733 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.