| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIAM D STAEDKE3 Filed as: WILLIAM D. STAEDKE | 25695 EAST 71ST STREET BROKEN ARROW, OK 74014 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $7K | $2K | $9K | 11.34% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | PO BOX 844501 DALLAS, TX 75284 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $7K | $506 | $7K | 9.16% |
| KELLY W PUGH3 Filed as: KELLY W. PUGH | 7367 SOUTH 286TH EAST AVENUE BROKEN ARROW, OK 74014 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $253 | $1K | 1.88% |
| ROSALINDA BENTANCUR3 | 2035 ALTA VISTA STREET HOUSTON, TX 77084 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $127 | — | $127 | 0.16% |
| MARYSOL N. CALVILLO3 | 5026 LONGLANE DRIVE HOUSTON, TX 77084 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $97 | — | $97 | 0.13% |
| HONORIO GUILLERMO AQUINO3 | 15 WATERFALL WAY WOODLANDS, TX 77375 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $44 | — | $44 | 0.06% |
| MARK PAGE3 | 311 MARSH OAKS DRIVE WILMINGTON, NC 28411 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $4 | — | $4 | 0.01% |
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 | 692 | 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) | 692 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF OKLAHOMA | 430 | $149K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 1,001 | $52K |
| Short-term disability | AMERICAN GENERAL LIFE INSURANCE COMPANY | 520 | $109K |
| Long-term disability | AMERICAN GENERAL LIFE INSURANCE COMPANY | 520 | $109K |
| Other(2 contracts, 2 carriers) | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 1,001 | $129K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,001 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.