| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | PO BOX 4047 CONCORD, CA 94524 | ROCKY MOUNTAIN HOSPITAL AND MEDICAL SERVICE, INC. | $29K | $0 | $29K | 2.81% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | 111 SOUTH TEJON STREET, SUITE 113 COLORADO SPRINGS, CO 80903 | HUMANADENTAL INSURANCE COMPANY | $4K | $0 | $4K | 3.12% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 3510 NORTH CAUSEWAY BOULEVARD SUITE 300 METAIRIE, LA 70002 | HUMANADENTAL INSURANCE COMPANY | $0 | $202 | $202 | 0.16% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | 1125 17TH STREET, SUITE 900 DENVER, CO 80202 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $11K | $4K | $15K | 13.64% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | 4371 LATHAM STREET, SUITE 101 RIVERSIDE, CA 92501 | KAISER FOUNDATION HEALTH PLAN OF HAWAII | $1K | $0 | $1K | 3.45% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | 111 SOUTH TEJON STREET, SUITE 113 COLORADO SPRINGS, CO 80903 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $6K | $0 | $6K | 15.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE | PO BOX 195556 SAN JUAN, PR 00919 | HUMANA HEALTH PLANS OF PUERTO RICO, INC. | $2K | $0 | $2K | 6.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE | PO BOX 844663 DALLAS, TX 75284 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | $3K | $0 | $3K | 11.32% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL PUERTO RICO INC | PO BOX 195556 SAN JUAN, PR 00919 | MULTINATIONAL LIFE INSURANCE COMPANY | $3K | $0 | $3K | 20.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE | 2000 SOUTH COLORADO BOULEVARD TOWER 2, SUITE 150 DENVER, CO 80222 | CONTINENTAL AMERICAN INSURANCE COMPANY | $2K | $0 | $2K | 30.57% |
| TONYA M DORMAN3 Filed as: TONYA M. DORMAN | 8569 VALLEY RANCH POINT FOUNTAIN, CO 80817 | CONTINENTAL AMERICAN INSURANCE COMPANY | $141 | $0 | $141 | 2.32% |
| CLINT WEIGHT3 | 745 SOUTH 180 WEST SALEM, UT 84653 | CONTINENTAL AMERICAN INSURANCE COMPANY | $31 | $0 | $31 | 0.51% |
| BRYAN R. DORMAN3 | 8569 VALLEY RANCH POINT FOUNTAIN, CO 80817 | CONTINENTAL AMERICAN INSURANCE COMPANY | $6 | $0 | $6 | 0.10% |
| THOMAS J PITZENBERGER3 Filed as: THOMAS J. PITZENBERGER | 1501 SUGARLAND PARKWAY PLEASANT HILL, MO 64080 | CONTINENTAL AMERICAN INSURANCE COMPANY | $3 | $0 | $3 | 0.05% |
| JONATHAN SAMUEL KIRKLAND3 Filed as: JONATHAN S. KIRKLAND | 4245 MILGEN ROAD COLUMBUS, GA 31907 | CONTINENTAL AMERICAN INSURANCE COMPANY | $2 | $0 | $2 | 0.03% |
| JOSE DE LOS SANTOS III3 Filed as: JOSE SANTOS AND VAROUS AGENTS | 155 INVERENS DRIVE WEST, SUITE 300 EDGLEWOOD, CO 80112 | CONTINENTAL AMERICAN INSURANCE COMPANY | $1 | $0 | $1 | 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 | 214 | 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) | 214 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | ROCKY MOUNTAIN HOSPITAL AND MEDICAL SERVICE, INC. | 176 | $1.1M |
| Dental(2 contracts, 2 carriers) | HUMANADENTAL INSURANCE COMPANY | 145 | $165K |
| Vision(2 contracts, 2 carriers) | HUMANA HEALTH PLANS OF PUERTO RICO, INC. | 310 | $60K |
| Life insurance(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 214 | $128K |
| Short-term disability(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 214 | $128K |
| Long-term disability(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 214 | $128K |
| Prescription drug(3 contracts, 3 carriers) | ROCKY MOUNTAIN HOSPITAL AND MEDICAL SERVICE, INC. | 176 | $1.1M |
| Other(6 contracts, 6 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 214 | $175K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 310 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.
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.