| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST LTD | 5314 S YALE AVE, SUITE 900 TULSA, OK 74135 | UNITEDHEALTHCARE INSURANCE COMPANY | — | $55K | $55K | 3.50% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL CFR, | 5314 S YALE, SUITE 900 TULSA, OK 74135 | DELTA DENTAL | $10K | — | $10K | 8.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST LTD | PO BOX 844501 DALLAS, TX 752844501 | UNUM LIFE INSURANCE CO OF AMERICA | $7K | $661 | $8K | 8.99% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST LTD | PO BOX 844501 DALLAS, TX 752844501 | VISION SERVICE PLAN | $1K | — | $1K | 5.28% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST LTD | PO BOX 844501 DALLAS, TX 752844501 | UNUM LIFE INSURANCE CO OF AMERICA | $2K | $88 | $2K | 15.75% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST LTD | PO BOX 844501 DALLAS, TX 752844501 | COLONIAL LIFE ACCIDENT INSURANCE CO. | $410 | $13 | $423 | 5.36% |
| WILLIAM D STAEDKE3 | 25695 E 71ST S BROKEN ARROW, OK 74014 | COLONIAL LIFE ACCIDENT INSURANCE CO. | $288 | $16 | $304 | 3.85% |
| MARILYN K EMBERSON3 Filed as: MARILYN EMBERSON | 7220 N HAMMOND AVENUE OKLAHOMA CITY, OK 73132 | COLONIAL LIFE ACCIDENT INSURANCE CO. | $207 | $6 | $213 | 2.70% |
| KELLY W PUGH3 | 7367 S 286TH EAST AVE BROKEN ARROW, OK 74014 | COLONIAL LIFE ACCIDENT INSURANCE CO. | $81 | $8 | $89 | 1.13% |
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 | 141 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 143 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITEDHEALTHCARE INSURANCE COMPANY | 295 | $1.6M |
| Dental | DELTA DENTAL | 137 | $120K |
| Vision | VISION SERVICE PLAN | 107 | $22K |
| Life insurance(3 contracts, 2 carriers) | UNUM LIFE INSURANCE CO OF AMERICA | 140 | $108K |
| Short-term disability | COLONIAL LIFE ACCIDENT INSURANCE CO. | 17 | $8K |
| Long-term disability | UNUM LIFE INSURANCE CO OF AMERICA | 140 | $88K |
| Other(2 contracts) | UNUM LIFE INSURANCE CO OF AMERICA | 140 | $100K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 295 | — |
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.