| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | 2000 SOUTH COLORADO BOULEVARD TOWER 2, SUITE 150 DENVER, CO 80222 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $4K | $0 | $4K | 10.00% |
| IMG5 | 2960 NORTH MERIDIAN STREET INDIANAPOLIS, IN 46208 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $0 | $21 | $21 | 0.05% |
| SUSAN C BANKS3 Filed as: SUSAN C. BANKS | 604 WILLOW BROOKE ROAD SILVERTHORNE, CO 80498 | CONTINENTAL AMERICAN INSURANCE COMPANY | $1K | $0 | $1K | 6.06% |
| TYLER NORD3 | 16377 JOSEPHINE PLACE THORNTON, CO 80602 | CONTINENTAL AMERICAN INSURANCE COMPANY | $228 | $0 | $228 | 1.18% |
| JAMES J SCHAMBER3 Filed as: JAMES J. SCHAMBER | 5700 EAST FRANKLIN ROAD, SUITE 110 NAMPA, ID 83687 | CONTINENTAL AMERICAN INSURANCE COMPANY | $151 | $0 | $151 | 0.78% |
| MJ INSURANCE3 Filed as: NANCY L. HARMON AND VARIOUS AGENTS | 3925 SOUTH QUATAR STREET AURORA, CO 80018 | CONTINENTAL AMERICAN INSURANCE COMPANY | $147 | $0 | $147 | 0.76% |
| SCOTT G GOFF3 Filed as: SCOTT G. GOFF | 12311 BOLBY CIRCLE TYLER, TX 75707 | CONTINENTAL AMERICAN INSURANCE COMPANY | $116 | $0 | $116 | 0.60% |
| LARRY HIGMAN3 | 34723 ROUNTY ROAD 21 ELIZABETH, CO 80107 | CONTINENTAL AMERICAN INSURANCE COMPANY | $56 | $0 | $56 | 0.29% |
| TIMOTHY B ASBY3 Filed as: TIMOTHY B. ASBY | 9247 NORTH MERIDIAN STREET SUITE 205 INDINAPOLIS, IN 46260 | CONTINENTAL AMERICAN INSURANCE COMPANY | $53 | $0 | $53 | 0.27% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | PO BOX 844663 DALLAS, TX 75284 | VISION SERVICE PLAN | $684 | $0 | $684 | 7.15% |
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 | 85 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 87 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | VISION SERVICE PLAN | 61 | $10K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 85 | $43K |
| Short-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 85 | $43K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 85 | $43K |
| Other(2 contracts, 2 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 166 | $63K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 166 | — |
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.