| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 | 4830 W. KENNEDY BLVD. STE 850 TAMPA, FL 33609 | STANDARD INSURANCE COMPANY | $27K | — | $27K | 9.97% |
| DIGITAL INSURANCE LLC3 | 200 GALLERIA PARKWAY LLC STE 1950 ATLANTA, GA 30339 | STANDARD INSURANCE COMPANY | — | $6K | $6K | 2.37% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | PO BOX 1027 CLEARWATER, FL 33757 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $33K | — | $33K | 14.99% |
| DIGITAL INSURANCE LLC3 | 200 GALLERIA PARKWAY SUITE 1950 ATLANTA, GA 30339 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $11K | $11K | 5.18% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | PO BOX 1027 CLEARWATER, FL 33757 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $15K | — | $15K | 15.00% |
| DIGITAL INSURANCE LLC3 | 200 GALLERIA PARKWAY SUITE 1950 ATLANTA, GA 30339 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $5K | $5K | 4.85% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 4830 W. KENNEDY BLVD. STE 850 TAMPA, FL 33609 | STANDARD INSURANCE COMPANY | $8K | — | $8K | 9.96% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE, LLC | 200 GALLERIA PARKWAY STE 1950 ATLANTA, GA 30339 | STANDARD INSURANCE COMPANY | — | $2K | $2K | 2.44% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | PO BOX 1027 CLEARWATER, FL 33757 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $7K | — | $7K | 10.00% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE, LLC | 200 GALLERIA PARKWAY SE STE 1950 ATLANTA, GA 30339 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $4K | $4K | 4.88% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | PO BOX 1027 CLEARWATER, FL 33757 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | — | $4K | 10.00% |
| DIGITAL INSURANCE LLC3 | 200 GALLERIA PARKWAY SUITE 1950 ATLANTA, GA 30339 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $2K | $2K | 4.89% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL-FL | 4830 W. KENNEDY BLVD. STE 850 TAMPA, FL 33609 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | — | $3K | 15.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | PO BOX 1027 CLEARWATER, FL 33757 | MUTUAL OF OMAHA INSURANCE COMPANY | $916 | — | $916 | 10.00% |
| DIGITAL INSURANCE LLC3 | 200 GALLERIA PARKWAY SUITE 1950 ATLANTA, GA 30339 | MUTUAL OF OMAHA INSURANCE COMPANY | — | $504 | $504 | 5.50% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| MERITAIN HEALTH EIN 16-1264154 CLAIMS ADMINISTRATOR | Claims processing Service code 12 | — | $193K |
| HUB INTERNATINOAL MIDWEST LIMITED INS BROKER | Other commissions Service code 55 | 4830 W. KENNEDY BLVD. STE 850 TAMPA, FL 33609 | $140K |
| MEDCOM BENEFIT SOLUTIONS EIN 59-2316866 FSA ADMIN | Contract Administrator; Claims processing Service code 12 | P.O. BOX 10269 JACKSONVILLE, FL 32204 | $8K |
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 | 557 | 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) | 557 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | STANDARD INSURANCE COMPANY | 452 | $267K |
| Vision | STANDARD INSURANCE COMPANY | 422 | $76K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 557 | $114K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 557 | $102K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 557 | $218K |
| Stop-loss / reinsurancereinsurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 421 | $1.4M |
| Other(3 contracts, 3 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 557 | $67K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 557 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.