| 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 | $1K | $8K | 9.92% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | PO BOX 844501 DALLAS, TX 75284 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $6K | $1K | $7K | 9.01% |
| KELLY W PUGH3 Filed as: KELLY W. PUGH | 7367 SOUTH 286TH EAST AVENUE BROKEN ARROW, OK 74014 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $116 | $1K | 1.56% |
| 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 | $86 | — | $86 | 0.11% |
| HONORIO GUILLERMO AQUINO3 | 15 WATERFALL WAY WOODLANDS, TX 77375 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $39 | — | $39 | 0.05% |
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 | 696 | 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) | 696 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 179 | $80K |
| Dental | DELTA DENTAL | 433 | $154K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 922 | $213K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 922 | $213K |
| Short-term disability(2 contracts, 2 carriers) | AMERICAN GENERAL LIFE INSURANCE COMPANY | 526 | $123K |
| Long-term disability(2 contracts, 2 carriers) | AMERICAN GENERAL LIFE INSURANCE COMPANY | 526 | $123K |
| Other(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 922 | $292K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 922 | — |
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.