| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | 7770 JEFFERSON STREET NE, SUITE 101 ALBUQUERQUE, NM 87109 | METROPOLITAN LIFE INSURANCE COMPANY | $72K | — | $72K | 7.16% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | PO BOX 5345 RIVERSIDE, CA 92517 | METROPOLITAN LIFE INSURANCE COMPANY | — | $15K | $15K | 1.54% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | PO BOX 844663 DALLAS, TX 75284 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $25K | — | $25K | 15.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | 55 EAST JACKSON, SUITE 600 CHICAGO, IL 60604 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $3K | $3K | 1.91% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC | 1125 17TH STREET, SUITE 900 DENVER, CO 80202 | RELIASTAR LIFE INSURANCE COMPANY | $54K | — | $54K | 60.48% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | PO BOX 844663 DALLAS, TX 75284 | VISION SERVICE PLAN | $2K | — | $2K | 3.07% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | 1125 17TH STREET DENVER, CO 80202 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $233 | $1 | $234 | 6.80% |
| JACQUELINE STUEMKY3 Filed as: JACQUELINE MARIE STUERNKY | PO BOX 5014 BUFFALO CREEK, CO 80425 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $91 | $19 | $110 | 3.20% |
| RYLEE ENTERPRISES INC3 Filed as: RYLEE ENTERPRISES AND OTHER AGENTS | 1828 OAK RIDGE ROAD OAK RIDGE, NC 27310 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $70 | $3 | $73 | 2.12% |
| JADE A. OSBORNE3 | PO BOX 7609 GREENSBORO, NC 27417 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $72 | — | $72 | 2.09% |
| MELISSA A KOLL3 Filed as: MELISSA RENFROE | 216 CLIMAX DRIVE DILLON, CO 80435 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $62 | $10 | $72 | 2.09% |
| BENEFITS COUNT INC3 Filed as: BENEFITS COUNT II, INC. | 248 RIVERWOOD DRIVE LEWISVILLE, NC 27023 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $29 | — | $29 | 0.84% |
| BENEFITS COUNT INC3 Filed as: BENEFITS COUNT I, INC. | 248 RIVERWOOD DRIVE LEWISVILLE, NC 27023 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $23 | — | $23 | 0.67% |
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 | 1,713 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 16 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,729 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | RELIASTAR LIFE INSURANCE COMPANY | 233 | $89K |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 3,364 | $1000K |
| Vision | VISION SERVICE PLAN | 801 | $71K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 3,364 | $1000K |
| Short-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 366 | $168K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 366 | $168K |
| Other(3 contracts, 3 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 3,364 | $1.1M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 3,364 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.