| 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 | COMMUNITYCARE HMO | $0 | $27K | $27K | 2.47% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MID-AMERICA | 6100 SOUTH YALE AVENUE, SUITE 1900 TULSA, OK 74136 | METROPOLITAN LIFE INSURANCE COMPANY | $6K | $59 | $6K | 6.64% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 16253 COLLECTION CENTER DRIVE CHICAGO, IL 60693 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $1K | $1K | 1.09% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 6100 SOUTH YALE AVENUE, SUITE 1900 TULSA, OK 74136 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $6K | $2K | $8K | 21.08% |
| WILLIAM D STAEDKE3 Filed as: WILLIAM D. STAEDKE | PO BOX 140803 BROKEN ARROW, OK 74014 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $284 | $12 | $296 | 5.02% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 6100 SOUTH YALE AVENUE, SUITE 1900 TULSA, OK 74136 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $293 | $0 | $293 | 4.96% |
| SHANNON MARIE BALDWIN3 | 14620 SOUTH 52ND EAST AVENUE BIXBY, OK 74008 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $87 | $0 | $87 | 1.47% |
| KELLY W PUGH3 Filed as: KELLY W. PUGH | 7367 SOUTH 286TH EASE AVENUE BROKEN ARROW, OK 74014 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $56 | $1 | $57 | 0.97% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MID-AMERICA | 6100 SOUTH YALE AVENUE, SUITE 1900 TULSA, OK 74136 | LEADERS LIFE INSURANCE COMPANY | $12 | $0 | $12 | 0.77% |
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 | 118 | 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) | 118 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | COMMUNITYCARE HMO | 189 | $1.1M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 277 | $93K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 277 | $93K |
| Life insurance(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 277 | $94K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 47 | $40K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 47 | $40K |
| Prescription drug | COMMUNITYCARE HMO | 189 | $1.1M |
| Other(4 contracts, 4 carriers) | COMMUNITYCARE HMO | 277 | $1.2M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 277 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.