| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MID-AMERICA | 6100 SOUTH YALE AVENUE, SUITE 1900 TULSA, OK 74136 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $0 | $7K | $7K | 4.16% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONALMIDWEST LTD | 3510 NORTH CAUSEWAY BOULEVARD SUITE 200 METAIRE, LA 70002 | SYMETRA LIFE INSURANCE COMPANY | $0 | $4K | $4K | 3.01% |
| WILLIAM D STAEDKE3 Filed as: WILLIAM D. STAEDKE | PO BOX 140803 BROKERN ARROW, OK 74014 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $4K | $340 | $5K | 7.09% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 6100 SOUTH YALE AVENUE, SUITE 1900 TULSA, OK 74132 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $4K | $242 | $4K | 6.24% |
| KELLY W PUGH3 Filed as: KELLY W. PUGH | 7367 SOUTH 286TH AVENUE BROKER ARROW, OK 74014 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $713 | $47 | $760 | 1.19% |
| MARYSOL N. CALVILLO3 | 5026 LANGLANE DRIVE HOUSTON, TX 77084 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $69 | $0 | $69 | 0.11% |
| ROSALINDA BENTANCUR RODRIGUEZ3 | 2035 ALTA VISTA STREET HOUSTON, TX 77023 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $66 | $0 | $66 | 0.10% |
| HONORIO GUILLERMO AQUINO3 | 2802 CARLA DRIVE ROWLETT, TX 75088 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $18 | $0 | $18 | 0.03% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 6100 SOUTH YALE AVENUE, SUITE 1900 TULSA, OK 74136 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $54 | $54 | 0.11% |
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 | 531 | 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) | 531 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL | 383 | $173K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 578 | $50K |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 745 | $158K |
| Short-term disability | SYMETRA LIFE INSURANCE COMPANY | 450 | $133K |
| Long-term disability | SYMETRA LIFE INSURANCE COMPANY | 450 | $133K |
| Other(3 contracts, 3 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 745 | $355K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 745 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.