| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL SERVICES INC | 1125 17TH ST STE 900 DENVER, CO 80202 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $11K | $4K | $16K | 20.66% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL SERVICES INC | 1125 17TH ST STE 900 DENVER, CO 80202 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $10K | $4K | $13K | 20.64% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL SERVICES INC | 1125 17TH ST STE 900 DENVER, CO 80202 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | $2K | $7K | 21.06% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SERVICE | PO BOX 2158 RIVERSIDE, CA 92516 | VISION SERVICE PLAN | $768 | $0 | $768 | 3.22% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCES INC | PO BOX 844663 DALLAS, TX 75284 | VISION SERVICE PLAN | $640 | $0 | $640 | 2.68% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL SERVICES INC | 1125 17TH ST STE 900 DENVER, CO 80202 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $550 | $3K | 19.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL COLORADO | 2000 S. COLORADO BLVD. TOWER 2, SUITE 150 DENVER, CO 80222 | NEW BENEFITS LTD | $106 | $0 | $106 | 0.94% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL SERVICES INC | 1125 17TH ST STE 900 DENVER, CO 80202 | MUTUAL OF OMAHA INSURANCE COMPANY | $834 | $421 | $1K | 22.57% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| MUTUAL OF OMAHA EIN 47-0246511 INSURANCE SERVICES | Insurance services Service code 23 | — | $154K |
| BENEFIT ADMINISTRATIVE SERVICES EIN 36-4197088 PLAN ADMINISTRATOR | Plan Administrator Service code 14 | — | $75K |
| HUB INTERNATIONAL INS. SVCES., INC. EIN 33-0315047 BROKER | Insurance agents and brokers Service code 22 | — | $73K |
| COFINITY EIN 20-1274723 PPO NETWORK | Insurance services Service code 23 | — | $34K |
| VISION SERVICE PLAN EIN 06-1227840 INSURANCE SERVICES | Insurance services Service code 23 | — | $24K |
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 | 156 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 14 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 6 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 176 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | NEW BENEFITS LTD | 174 | $11K |
| Vision | VISION SERVICE PLAN | 137 | $24K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 165 | $110K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 29 | $14K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 164 | $65K |
| Stop-loss / reinsurancereinsurance | HM LIFE | 170 | $673K |
| Other(3 contracts, 3 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 165 | $87K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 174 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.