| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MID-AMERICA | 425 WEST CAPITAL AVENUE, SUITE 3550 LITTLE ROCK, AR 72201 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $3K | $0 | $3K | 1.44% |
| KEVIN S. RIBERA3 | PO BOX 502 BOKCHITO, OK 74726 | AFLAC | $868 | $8 | $876 | 3.95% |
| RICHARD L. HARWOOD AND OTHER AGENTS3 | PO BOX 333 HUDSON, NC 28638 | AFLAC | $817 | $8 | $825 | 3.72% |
| REBECCA K BOXFORD3 Filed as: REBECCA K. BOXFORD | 5205 DUSTY LANE GRANITE FALLS, NC 28630 | AFLAC | $586 | $19 | $605 | 2.73% |
| JOSHUA WORTHY3 | 2929 WEST MAIN STREET DURANT, OK 74701 | AFLAC | $496 | $0 | $496 | 2.24% |
| TIMOTHY W WORTHY JR3 Filed as: TIMOTHY W. WORTHY JR. | 2929 WEST MAIN STREET DURANT, OK 74701 | AFLAC | $302 | $2 | $304 | 1.37% |
| LOYTALIA RIBERA3 Filed as: LOYTALIA E. RIBERA | PO BOX 502 BOKCHITO, OK 74726 | AFLAC | $267 | $0 | $267 | 1.21% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHWEST LLC | 415 NORTH 2ND STREET, SUITE A YAKIMA, WA 98901 | AFLAC | $1 | $0 | $1 | 0.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 6100 SOUTH YALE, SUITE 1900 TULSA, OK 74136 | OPTUMHEALTH CARE SOLUTIONS | $470 | $0 | $470 | 2.65% |
| HEALTHCARE SOLUTIONS GROUP, INC.3 | PO BOX 1309 MUSKOGEE, OK 74402 | OPTUMHEALTH CARE SOLUTIONS | $469 | $0 | $469 | 2.65% |
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 | 200 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 202 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 233 | $233K |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 233 | $233K |
| Short-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 233 | $233K |
| Long-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 233 | $233K |
| Other(3 contracts, 3 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 233 | $273K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 233 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.