| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MID-AMERICA | 6100 S. YALE AVE., STE 1900 TULSA, OK 74136 | COMMUNITYCARE | $38K | — | $38K | 4.56% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL HOLMES ORGANISATI | 6100 S. YALE AVE., STE 1900 TULSA, OK 74136 | DELTA DENTAL | $4K | — | $4K | 8.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 1600 S. YALE AVE., STE. 1900 TULSA, OK 74136 | PRUDENTIAL | $602 | — | $602 | 5.40% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 3635 RIVERSIDE PLAZA DRIVE, STE 300 RIVERSIDE, CA 92506 | PRUDENTIAL | $484 | — | $484 | 4.34% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | C/O BANK OF AMERICA CHICAGO, IL 60693 | EYE MED | $631 | — | $631 | 8.51% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | PO BOX 2167 GRAND RAPIDS, MI 49501 | EYE MED | $128 | — | $128 | 1.73% |
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 | 127 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 127 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | COMMUNITYCARE | 165 | $822K |
| Dental | DELTA DENTAL | 168 | $54K |
| Vision | EYE MED | 60 | $7K |
| Life insurance | PRUDENTIAL | 127 | $11K |
| Other(2 contracts, 2 carriers) | PRUDENTIAL | 475 | $17K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 475 | — |
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.