| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVC INC | 1125 17TH ST STE 900 DENVER, CO 80202 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $17K | $14K | $30K | 18.34% |
| WEB BENEFITS DESIGN CORPORATION5 Filed as: WEB BENEFITS DESIGN CORP | 4725 W SAND LAKE RD STE 300 ORLANDO, FL 32819 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $25K | $25K | 15.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS, INC | PO BOX 844663 DALLAS, TX 752844663 | VISION SERVICE PLAN | $3K | — | $3K | 2.23% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVC INC | 1125 17TH ST STE 900 DENVER, CO 80202 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $12K | $12K | 8.11% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVC INC | 1125 17TH ST STE 900 DENVER, CO 80202 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $8K | $8K | 7.94% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVC INC | 1125 17TH ST STE 900 DENVER, CO 80202 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $8K | $6K | $14K | 18.25% |
| WEB BENEFITS DESIGN CORPORATION5 Filed as: WEB BENEFITS DESIGN CORP | 4725 W SAND LAKE RD STE 300 ORLANDO, FL 32819 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $11K | $11K | 15.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVC INC | 1125 17TH ST STE 900 DENVER, CO 80202 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $7K | $5K | $12K | 17.98% |
| WEB BENEFITS DESIGN CORPORATION5 Filed as: WEB BENEFITS DESIGN CORP | 4725 W SAND LAKE RD STE 300 ORLANDO, FL 32819 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $10K | $10K | 15.00% |
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 | 1,153 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 11 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,164 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts) | BLUECROSS BLUESHIELD OF NEW MEXICO | 1,085 | $6.9M |
| Dental | DELTA DENTAL OF NEW MEXICO | 1,453 | $393K |
| Vision | VISION SERVICE PLAN | 769 | $145K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 1,153 | $173K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 152 | $165K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 1,153 | $142K |
| Other(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 1,153 | $165K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,453 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.