| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHWEST LLC | 12100 NORTHEAST 195TH STREET BOTHELL, WA 98011 | AETNA LIFE INSURANCE CO. | $27K | — | $27K | 1.95% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHWEST LLC | — | DELTA DENTAL OF WASHINGTON | $6K | — | $6K | 5.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHWEST LLC | 2632 SOUTH CORBIN CIRCLE GREENACRES, WA 99016 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | — | $1K | 8.64% |
| AXIS INSURANCE LLC3 | 155 108TH AVENUE NE SUITE 725 BELLEVUE, WA 98004 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $977 | — | $977 | 5.86% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHWEST LLC | PO BOX 3018 BOTHELL, WA 98041 | VISION SERVICE PLAN | $881 | — | $881 | 6.45% |
| AXIS INSURANCE LLC3 | PO BOX 90007 BELLEVUE, WA 98009 | VISION SERVICE PLAN | $1 | — | $1 | 0.01% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHWEST LLC | 2632 SOUTH CORBIN CIRCLE GREENACRES, WA 99016 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $743 | — | $743 | 5.74% |
| AXIS INSURANCE LLC3 | 155 108TH AVENUE NORTHEAST SUITE 725 BELLEVUE, WA 98004 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $551 | — | $551 | 4.26% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHWEST LLC | 2632 SOUTH CORBIN CIRCLE GREENACRES, WA 99016 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | — | $1K | 14.21% |
| AXIS INSURANCE LLC3 | 155 108TH AVENUE NORTHEAST SUITE 725 BELLEVUE, WA 98004 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | — | $1K | 10.79% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHWEST LLC | 2632 SOUTH CORBIN CIRCLE GREENACRES, WA 99016 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $527 | — | $527 | 6.17% |
| AXIS INSURANCE LLC3 | 155 108TH AVENUE NORTHEAST SUITE 725 BELLEVUE, WA 98004 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $328 | — | $328 | 3.84% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHWEST LLC | 2632 SOUTH CORBIN CIRCLE GREENACRES, WA 99016 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $193 | — | $193 | 3.19% |
| AXIS INSURANCE LLC3 | 155 108TH AVENUE NORTHEAST SUITE 725 BELLEVUE, WA 98004 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $109 | — | $109 | 1.80% |
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 | 314 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 315 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | AETNA LIFE INSURANCE CO. | 231 | $1.4M |
| Dental | DELTA DENTAL OF WASHINGTON | 198 | $119K |
| Vision | VISION SERVICE PLAN | 179 | $14K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 304 | $23K |
| Short-term disability(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 25 | $11K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 82 | $17K |
| Other(3 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 304 | $29K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 304 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.
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.