| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | 1125 17TH STREET, SUITE 900 DENVER, CO 80202 | UNITED HEALTHCARE INSURANCE COMPANY | $16K | $340 | $17K | 4.33% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | 1125 17TH STREET, SUITE 900 DENVER, CO 80202 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $8K | $3K | $11K | 15.50% |
| REUBEN WARNER ASSOCIATES, INC.3 Filed as: WARNER PACIFIC INSURANCE SERVICES | 32110 AGOURA ROAD WESTLAKE VILLAGE, CA 91361 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $3K | $3K | 5.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | 1125 17TH STREET, SUITE 900 DENVER, CO 80202 | AFLAC | $3K | $0 | $3K | 21.74% |
| KYLE AUSTIN DORMAN3 | 8569 VALLEY RANCH POINT FOUNTAIN, CO 80817 | AFLAC | $2K | $32 | $2K | 13.46% |
| TONYA M DORMAN3 Filed as: TONYA M. DORMAN | 8569 VALLEY RANCH POINT FOUNTAIN, CO 80817 | AFLAC | $796 | $0 | $796 | 5.07% |
| ZAKERY ALLEN HARLOW3 | 2960 NORTH ACADEMY BOULEVARD SUITE 101 COLORADO SPRINGS, CO 80917 | AFLAC | $400 | $0 | $400 | 2.55% |
| JACOB AGUERO3 | 7807 TREEHOUSE TERRACE FOUNTAIN, CO 80817 | AFLAC | $362 | $0 | $362 | 2.31% |
| JENNIFER L FOSS3 Filed as: JENNIFER L. FOSS | 9034 EAST EASTER PLACE, SUITE 202 CENTENNIAL, CO 80112 | AFLAC | $362 | $0 | $362 | 2.31% |
| JENNIFER L FREEMAN3 Filed as: JENNIFER L. FREEMAN | 4879 STREAMBED TRAIL PARKER, CO 80134 | AFLAC | $3 | $0 | $3 | 0.02% |
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 | 150 | 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) | 150 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITED HEALTHCARE INSURANCE COMPANY | 102 | $386K |
| Dental | UNITED HEALTHCARE INSURANCE COMPANY | 102 | $386K |
| Vision | UNITED HEALTHCARE INSURANCE COMPANY | 102 | $386K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 150 | $70K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 150 | $70K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 150 | $70K |
| Prescription drug | UNITED HEALTHCARE INSURANCE COMPANY | 102 | $386K |
| Other(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 150 | $85K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 150 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.