| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE | 1125 17TH STREET STE 900 DENVER, CO 80202 | BLUE CROSS BLUE SHIELD OF NEW MEXICO | $17K | $0 | $17K | 2.82% |
| JANICE ANDERSON3 Filed as: JANICE MARIE ANDERSON | 5812 WEST HOOVER PLACE LITTLETON, CO 80123 | BLUE CROSS BLUE SHIELD OF NEW MEXICO | $4K | $0 | $4K | 0.68% |
| JANICE ANDERSON3 | 5812 WEST HOOVER PLACE LITTLETON, CO 80123 | UNITED HEALTHCARE INSURANCE COMPANY | $2K | $8K | $10K | 3.28% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SERVICES INC. | 1125 17TH STREET STE 900 DENVER, CO 80202 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $6K | $2K | $8K | 12.09% |
| JANICE ANDERSON3 | 5812 WEST HOOVER PLACE LITTLETON, CO 80123 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $940 | $0 | $940 | 1.50% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL OF CALIFORNIA | 2375 E CAMELBACK ROAD PHOENIX, AZ 85016 | PRINCIPAL | $2K | $0 | $2K | 3.93% |
| JANICE ANDERSON3 | 5812 WEST HOOVER PLACE LITTLETON, CO 80123 | PRINCIPAL | $880 | $0 | $880 | 1.53% |
| JANICE ANDERSON3 | 5812 WEST HOOVER PLACE LITTLETON, CO 80123 | UNITEDHEALTHCARE INSURANCE COMPANY | $4K | $0 | $4K | 10.20% |
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 | 116 | 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. |
| Beneficiaries receiving benefits | 0 | Spouses or dependents with eligibility independent of the participant. |
| Total participants (= "Plan participants" tile) | 116 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF NEW MEXICO | 0 | $899K |
| Dental(2 contracts, 2 carriers) | UNITED HEALTHCARE INSURANCE COMPANY | 74 | $352K |
| Vision(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF NEW MEXICO | 0 | $899K |
| Life insurance(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 113 | $97K |
| Short-term disability(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 113 | $97K |
| Long-term disability(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 113 | $97K |
| Prescription drug | UNITED HEALTHCARE INSURANCE COMPANY | 0 | $294K |
| Other(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 113 | $97K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 113 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.