| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHWEST LLC | 12100 NORTHEAST 195TH STREET SUITE 200 BOTHELL, WA 98041 | REGENCE BLUECROSS BLUESHIELD OF OREGON | $55K | — | $55K | 1.00% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH AND BENEFITS | 111 SOUTHWEST COLUMBIA, SUITE 500 PORTLAND, OR 97201 | REGENCE BLUECROSS BLUESHIELD OF OREGON | $11 | $6K | $6K | 0.11% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHWEST LLC | PO BOX 3018 SUITE 200 BOTHELL, WA 98041 | METROPOLITAN LIFE INSURANCE COMPANY | $29K | $45 | $29K | 5.52% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH AND BENEFITS | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $4K | $4K | 0.70% |
| BCI GROUP, INC.3 Filed as: BCI GROUP | 6979 SOUTHEAST LAKE ROAD PORTLAND, OR 97267 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $10K | $3K | $13K | 5.22% |
| HEARTSEASE LLC3 | 1521 NORTHEAST 236TH AVENUE HILLSBORO, OR 97124 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $9K | $5K | $14K | 11.52% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHWEST LLC | PO BOX 2158 RIVERSIDE, CA 92516 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $4K | $0 | $4K | 3.47% |
| WORKSITE BENEFITS GROUP INC3 | 112 NORTHWEST 114TH STREET VANCOUVER, WA 98685 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $2K | $3K | 2.95% |
| MJ INSURANCE3 Filed as: PAMELA C. SMITH AND VARIOUS AGENTS | 411 HIGHLAND DRIVE SEATTLE, WA 98109 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $3K | $361 | $3K | 2.73% |
| KAREN CLAY KUNKLER3 | 1709 NORTHWEST 45TH AVENUE CAMAS, WA 98607 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $827 | $3K | 2.71% |
| BENEFITS BY DESIGN INC3 | 2101 NORTHEAST 279TH STREET RIDGEFIELD, WA 98642 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $464 | $2K | 1.97% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH AND BENEFITS | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $0 | $2K | 1.41% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH AND BENEFITS | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | VISION SERVICE PLAN | $579 | $0 | $579 | 0.83% |
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 | 677 | 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) | 677 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | REGENCE BLUECROSS BLUESHIELD OF OREGON | 912 | $5.5M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 1,202 | $523K |
| Vision | VISION SERVICE PLAN | 467 | $70K |
| Life insurance(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 677 | $362K |
| Short-term disability | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 200 | $117K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 677 | $245K |
| Prescription drug | REGENCE BLUECROSS BLUESHIELD OF OREGON | 912 | $5.5M |
| Other(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 677 | $362K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,202 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.