| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: FOX EVERETT-DIV OF HUB INTL | 300 CONCOURSE BLVD, STE 300 RIDGELAND, MS 39157 | UNUM | $38K | — | $38K | 10.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | P.O. BOX 6650 METAIRIE, LA 70009 | METROPOLITAN LIFE INSURANCE COMPANY | $19K | $59 | $19K | 10.87% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 16253 COLLECTION CENTER DRIVE CHICAGO, IL 60693 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $3K | $3K | 1.85% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST LTD | 2487 CEDARCREST ROAD, STE 122 ACWORTH, GA 30101 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $15K | $7K | $22K | 21.77% |
| WEB BENEFITS DESIGN CORPORATION5 Filed as: WEB BENEFITS DESIGN CORP | 4725 W. SAND LAKE RD, STE 300 ORLANDO, FL 32819 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $10K | $10K | 10.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST LTD | 2487 CEDARCREST ROAD, STE 122 ACWORTH, GA 30101 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $10K | $4K | $14K | 21.77% |
| WEB BENEFITS DESIGN CORPORATION5 Filed as: WEB BENEFITS DESIGN CORP | 4725 W. SAND LAKE RD, STE 300 ORLANDO, FL 32819 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $6K | $6K | 10.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST LTD | 2487 CEDARCREST ROAD, STE 122 ACWORTH, GA 30101 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $10K | $4K | $14K | 21.84% |
| WEB BENEFITS DESIGN CORPORATION5 Filed as: WEB BENEFITS DESIGN CORP | 4725 W. SAND LAKE RD, STE 300 ORLANDO, FL 32819 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $6K | $6K | 10.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST LTD | 2487 CEDARCREST ROAD, STE 122 ACWORTH, GA 30101 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $1K | $5K | 21.91% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST LTD | 2487 CEDARCREST ROAD, STE 122 ACWORTH, GA 30101 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $1K | $3K | 21.80% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST LTD | 2487 CEDARCREST ROAD, STE 122 ACWORTH, GA 30101 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $865 | $3K | 21.82% |
| WEB BENEFITS DESIGN CORPORATION5 Filed as: WEB BENEFITS DESIGN CORP | 4725 W. SAND LAKE RD, STE 300 ORLANDO, FL 32819 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $1K | $1K | 10.00% |
| HUB INTERNATIONAL MIDWEST LIMITED4 Filed as: HUB INTERNATIONAL MIDWEST LTD | 2487 CEDARCREST RD, STE 122 ACWORTH, GA 30101 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $1K | — | $1K | 8.82% |
| J KEEBS & ASSOCIATES4 Filed as: J KEEBS & ASSOCIATES LLC | 1810 BLOSSOM CREEK LN CUMMING, GA 30040 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $342 | — | $342 | 2.91% |
| TRACEY FORRESTER4 | 10115 MEMOIR AVE WINTER GARDEN, FL 34787 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $47 | — | $47 | 0.40% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| FOX EVERETT OF HUB INTERNATIONAL EIN 35-0672425 CONTRACT ADMINISTRATOR | Claims processing; Contract Administrator Service code 12 | — | $156K |
| AETNA LIFE INSURANCE COMPANY EIN 06-6033492 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | — | $43K |
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 | 236 | 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) | 236 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 418 | $176K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 418 | $176K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 392 | $13K |
| Stop-loss / reinsurancereinsurance | UNUM | 173 | $380K |
| Other(7 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 392 | $291K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 418 | — |
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.