| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| SILBERSTEIN INSURANCE GROUP3 Filed as: RICHARD B. SILBERSTEIN | 2850 QUARRY LAKE DRIVE SUITE 303 BALTIMORE, MD 21209 | KAISER PERMANENTE | $18K | $1K | $19K | 3.31% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | 425 ASHLEY RIDGE SUITE 230 SHREVPORT, LA 71106 | KAISER PERMANENTE | $11K | $0 | $11K | 1.82% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | 421 W 3RD STREET SUITE 800 FORT WORTH, TX 76102 | MUTUAL OF OMAHA INSURANCE COMPANY | $88K | $30K | $119K | 25.54% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | 700 NORTH PEARL STREET SUITE N1700 DALLAS, TX 75201 | STARMOUNT LIFE INSURANCE COMPANY | $44K | $0 | $44K | 10.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | UNKNOWN SYKESVILLE, MD 21784 | COMBINED INSURANCE COMPANY | $115K | $0 | $115K | 69.98% |
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 | 1,271 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,273 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER PERMANENTE | 71 | $584K |
| Dental | STARMOUNT LIFE INSURANCE COMPANY | 917 | $437K |
| Vision | STARMOUNT LIFE INSURANCE COMPANY | 917 | $437K |
| Life insurance | MUTUAL OF OMAHA INSURANCE COMPANY | 704 | $466K |
| Short-term disability | MUTUAL OF OMAHA INSURANCE COMPANY | 704 | $466K |
| Long-term disability | MUTUAL OF OMAHA INSURANCE COMPANY | 704 | $466K |
| Prescription drug | KAISER PERMANENTE | 71 | $584K |
| Other | COMBINED INSURANCE COMPANY | 1,271 | $165K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,271 | — |
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.