| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHWEST, LLC | 12100 NE 195TH STREET, SUITE 200 BOTHELL, WA 98041 | REGENCE BLUECROSS BLUESHIELD OF OREGON | $40K | $0 | $40K | 0.65% |
| LOCKTON COMPANIES, LLC3 | 3 CENTERPOINTE DRIVE, SUITE 320 LAKE OSWEGO, OR 97035 | REGENCE BLUECROSS BLUESHIELD OF OREGON | $21K | $0 | $21K | 0.34% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHWEST, LLC | PO BOX 3018 BOTHELL, WA 98041 | METROPOLITAN LIFE INSURANCE COMPANY | $24K | $5K | $29K | 5.42% |
| LOCKTON COMPANIES, LLC3 | 600 UNIVERSITY STREET, SUITE 1900 SEATTLE, WA 98101 | METROPOLITAN LIFE INSURANCE COMPANY | $8K | $87 | $8K | 1.55% |
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $2K | $2K | 0.32% |
| BCI GROUP, INC.3 Filed as: BCI GROUP | 6979 SE LAKE ROAD PORTLAND, OR 97267 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $9K | $3K | $12K | 4.46% |
| LOCKTON COMPANIES, LLC3 | PO BOX 650823 DALLAS, TX 75265 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | $0 | $1K | 0.39% |
| HEARTSEASE LLC3 Filed as: HEARTSEASE, LLC | 1521 NE 63RD AVENUE HILLSBORO, OR 97124 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $8K | $5K | $13K | 9.22% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHWEST, LLC | PO BOX 2158 RIVERSIDE, CA 92516 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $9K | $0 | $9K | 6.46% |
| WORKSITE BENEFITS GROUP INC3 Filed as: WORKSITE BENEFITS GROUP, INC. | 112 NW 114TH STREET VANCOUVER, WA 98685 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $1K | $3K | 2.04% |
| BENEFIT BY DESIGN, INC.3 | 2101 NE 279TH STREET RIDGEFIELD, WA 98642 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $376 | $2K | 1.35% |
| PAMELA COPLE SMITH3 Filed as: PAMELA COPLE SMITH AND OTHER AGENTS | 411 HIGHLAND DRIVE SEATTLE, WA 98109 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $940 | $129 | $1K | 0.74% |
| KAREN CLAY KUNKLER3 | 415 SE 177TH AVENUE, UNIT 236 VANCOUVER, WA 98683 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $821 | $49 | $870 | 0.60% |
| LOCKTON COMPANIES, LLC3 | 4275 EXECUTIVE SQUARE, SUITE 600 LA JOLLA, CA 92037 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $509 | $0 | $509 | 0.35% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHWEST, LLC | PO BOX 3018 BOTHELL, WA 98041 | VISION SERVICE PLAN | $2K | $0 | $2K | 2.29% |
| LOCKTON COMPANIES, LLC3 | PO BOX 650823 DALLAS, TX 75265 | VISION SERVICE PLAN | $1K | $0 | $1K | 1.60% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHWEST, LLC | PO BOX 2158 RIVERSIDE, CA 92516 | VISION SERVICE PLAN | -$1 | $0 | -$1 | -0.00% |
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 | 702 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 9 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 711 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | REGENCE BLUECROSS BLUESHIELD OF OREGON | 975 | $6.1M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 1,250 | $541K |
| Vision | VISION SERVICE PLAN | 507 | $86K |
| Life insurance(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 702 | $418K |
| Short-term disability | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 199 | $145K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 702 | $274K |
| Prescription drug | REGENCE BLUECROSS BLUESHIELD OF OREGON | 975 | $6.1M |
| Other(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 702 | $418K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,250 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.