| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL CFR | 6100 S YALE STE. 1900 TULSA, OK 74136 | DELTA DENTAL | $6K | $13K | $20K | 12.44% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 6100 S YALE STE. 1900 TULSA, OK 74136 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $4K | $7K | $11K | 7.67% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 6100 S YALE STE. 1900 TULSA, OK 74136 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $3K | $3K | $6K | 10.01% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 6100 S YALE STE. 1900 TULSA, OK 74136 | VISION SERVICE PLAN | $5K | $16K | $21K | 45.49% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 6100 S YALE STE. 1900 TULSA, OK 74136 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $2K | — | $2K | 15.00% |
| BLUE CROSS BLUE SHIELD OF FLORIDA3 Filed as: BLUE CROSS BLUE SHIELD | 1400 S BOSTON TULSA, OK 74119 | HEALTH CARE SERVICE CORPORATION | — | $178K | $178K | — |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 6100 S YALE STE. 1900 TULSA, OK 74136 | HEALTH CARE SERVICE CORPORATION | $41K | — | $41K | — |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HEALTH CARE SERVICE CORPORATION NONE | Other services; Participant communication; Claims processing; Direct payment from the plan Service code 12 | — | $178K |
| HUB INTERNATIONAL NONE | Direct payment from the plan; Claims processing; Participant communication Service code 12 | 300 N LASALLIE ST, 17TH F TULSA, OK 60654 | $60K |
| EMPYREAN BENEFIT SOLUTIONS, INC. EIN 20-3029813 NONE | Direct payment from the plan; Participant communication; Claims processing Service code 12 | 3010 BRIARPARK DR 8000 HOUSTON, TX 77042 | $34K |
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 | 0 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 0 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 378 | $86K |
| Dental | DELTA DENTAL | 273 | $159K |
| Vision | VISION SERVICE PLAN | 381 | $45K |
| Life insurance | RELIANCE STANDARD LIFE INSURANCE COMPANY | 373 | $140K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 514 | $63K |
| Stop-loss / reinsurancereinsurance | HEALTH CARE SERVICE CORPORATION | 0 | $0 |
| Other(2 contracts) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 373 | $150K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 514 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Final-filing indicator set. Plan is winding down; don't waste sales effort here.