| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHWEST LLC | PO BOX 10167 EUGENE, OR 97440 | PACIFICSOURCE HEALTH PLANS | $69K | $0 | $69K | 4.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHWEST LLC | PO BOX 3018 BOTHELL, WA 98041 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $17K | $0 | $17K | 6.73% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHWEST LLC | UNKNOWN MEDFORD, OR 97504 | WILLAMETTE DENTAL INSURANCE, INC. | $1K | $0 | $1K | 5.27% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHWEST LLC | PO BOX 10167 EUGENE, OR 97440 | VISION SERVICE PLAN | $916 | $0 | $916 | 6.25% |
| ENROLLEASE3 Filed as: ENROLLEASE, INC | 1980 FESTIVAL PLAZA DRIVE SUITE 810 LAS VEGAS, NV 89135 | VISION SERVICE PLAN | $106 | $0 | $106 | 0.72% |
| WATCHTOWER TECHNOLOGIES INC3 | 306 WEST ERIE STREET, SUITE 300 CHICAGO, IL 60654 | VISION SERVICE PLAN | $73 | $0 | $73 | 0.50% |
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 | 97 | 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) | 97 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | PACIFICSOURCE HEALTH PLANS | 130 | $1.7M |
| Dental(2 contracts, 2 carriers) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 102 | $267K |
| Vision | VISION SERVICE PLAN | 80 | $15K |
| Life insurance | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 102 | $247K |
| Short-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 102 | $247K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 102 | $247K |
| Prescription drug | PACIFICSOURCE HEALTH PLANS | 130 | $1.7M |
| Other | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 102 | $247K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 130 | — |
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.
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.