| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF FLORIDA3 Filed as: BLUE CROSS BLUE SHIELD | 1400 S BOSTON TULSA, OK 74119 | HEALTH CARE SERVICE CORPORATION | — | $180K | $180K | 50.07% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 6100 S YALE, STE 1900 TULSA, OK 74136 | HEALTH CARE SERVICE CORPORATION | $40K | — | $40K | 11.14% |
| EMPLOYEE BENEFITS ADVANTAGE LLC3 | 6100 S YALE, STE 1900 TULSA, OK 74136 | DELTA DENTAL | $6K | $15K | $21K | 13.19% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 6100 S YALE, STE 1900 TULSA, OK 74136 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $4K | $6K | $10K | 8.04% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 6100 S YALE, STE 1900 TULSA, OK 74136 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $3K | $3K | $6K | 10.20% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 6100 S YALE STE. 1900 TULSA, OK 74136 | VISION SERVICE PLAN | $5K | — | $5K | 10.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 6100 S YALE, STE 1900 TULSA, OK 74136 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $2K | — | $2K | 15.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HEALTH CARE SERVICE CORPORATION EIN 36-1236610 NONE | Direct payment from the plan; Claims processing; Participant communication; Other services Service code 12 | — | $180K |
| HUB INTERNATIONAL NONE | Direct payment from the plan; Participant communication; Claims processing Service code 12 | 300 N LASALLIE ST, 17TH F TULSA, OK 60654 | $64K |
| WEB BENEFITS DESIGN NONE | Participant communication; Claims processing; Direct payment from the plan Service code 12 | 4725 SAND LAKE RD ORLANDO, FL 32819 | $37K |
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 | 391 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 394 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN INC | 11 | $81K |
| Dental | DELTA DENTAL | 289 | $158K |
| Vision | VISION SERVICE PLAN | 372 | $49K |
| Life insurance | RELIANCE STANDARD LIFE INSURANCE COMPANY | 370 | $122K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 369 | $61K |
| Stop-loss / reinsurancereinsurance | HEALTH CARE SERVICE CORPORATION | 461 | $359K |
| Other(3 contracts, 2 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 391 | $138K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 461 | — |
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.