| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST LTD | 6100 SOUTH YALE AVENUE, SUITE 1900 TULSA, OK 74135 | SYMETRA LIFE INSURANCE COMPANY | $0 | $15K | $15K | 5.02% |
| WILLIAM D STAEDKE3 Filed as: WILLIAM D. STAEDKE | PO BOX 140803 BROKEN ARROW, OK 74014 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $5K | $262 | $6K | 8.15% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 6100 SOUTH YALE AVENUE, SUITE 1900 TULSA, OK 74132 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $5K | $503 | $5K | 7.49% |
| KELLY W PUGH3 Filed as: KELLY W. PUGH | 7367 SOUTH 286TH EAST AVENUE BROKEN ARROW, OK 74014 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $876 | $38 | $914 | 1.31% |
| MARYSOL N. CALVILLO3 | 5026 LONGLANE DRIVE HOUSTON, TX 77084 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $53 | $0 | $53 | 0.08% |
| ROSALINDA BENTANCUR RODRIGUEZ3 | 2035 ALTA VISTA STREET HOUSTON, TX 77023 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $39 | $0 | $39 | 0.06% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 6100 SOUTH YALE, SUITE 1900 TULSA, OK 74136 | METROPOLITAN LIFE INSURANCE COMPANY | — | $47 | $47 | 0.10% |
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 | 706 | 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) | 706 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL | 393 | $181K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 588 | $49K |
| Life insurance | SYMETRA LIFE INSURANCE COMPANY | 706 | $305K |
| Short-term disability | SYMETRA LIFE INSURANCE COMPANY | 706 | $305K |
| Long-term disability | SYMETRA LIFE INSURANCE COMPANY | 706 | $305K |
| Other(2 contracts, 2 carriers) | SYMETRA LIFE INSURANCE COMPANY | 706 | $374K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 706 | — |
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."
No prospect flags tripped on this filing.