| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WOODRUFF-SAWYER & CO3 | 50 CALIFORNIA STREET FLOOR 12 SAN FRANCISCO, CA 94111 | KAISER FOUNDATION HEALTH PLAN INC. | — | $97 | $97 | 0.01% |
| WOODRUFF-SAWYER & CO3 | 50 CALIFORNIA STREET, FLOOR 12 SAN FRANCISCO, CA 94111 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $2K | $7K | $9K | 5.05% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NW LLC | 2 CENTERPOINTE DR STE 650 LAKE OSWEGO, OR 97035 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | — | $4K | 8.69% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NW LLC | PO BOX 749083 LOS ANGELES, CA 90074 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $3K | $3K | 6.42% |
| BENEFIT & RISK MGMT. SERVICES3 | 80 IRON POINT CIR STE 200 FOLSOM, CA 95630 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $688 | $688 | 1.57% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NW LLC | 2 CENTERPOINTE DR STE 650 LAKE OSWEGO, OR 97035 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | — | $4K | 15.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NW LLC | PO BOX 749083 LOS ANGELES, CA 90074 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $2K | $2K | 6.38% |
| BENEFIT & RISK MGMT. SERVICES3 | 80 IRON POINT CIR STE 200 FOLSOM, CA 95630 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $267 | $267 | 0.91% |
| WOODRUFF-SAWYER & CO3 | 50 CALIFORNIA STREET FLOOR 12 SAN FRANCISCO, CA 94111 | KAISER FOUNDATION HEALTH PLAN INC. | — | $3 | $3 | 0.01% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NW LLC | 2 CENTERPOINTE DR STE 650 LAKE OSWEGO, OR 97035 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | — | $1K | 10.00% |
| BENEFIT & RISK MGMT. SERVICES3 | 80 IRON POINT CIR STE 200 FOLSOM, CA 95630 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $877 | $877 | 8.06% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NW LLC | PO BOX 749083 LOS ANGELES, CA 90074 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $669 | $669 | 6.15% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NW LLC | 2 CENTERPOINTE DR STE 650 LAKE OSWEGO, OR 97035 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $973 | — | $973 | 15.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NW LLC | PO BOX 749083 LOS ANGELES, CA 90074 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $467 | $467 | 7.20% |
| BENEFIT & RISK MGMT. SERVICES3 | 80 IRON POINT CIR STE 200 FOLSOM, CA 95630 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $170 | $170 | 2.62% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NW LLC | 2 CENTERPOINTE DR STE 650 LAKE OSWEGO, OR 97035 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $430 | — | $430 | 15.01% |
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 | 139 | 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) | 139 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 2 carriers) | UNITEDHEALTHCARE INSURANCE COMPANY | 133 | $2.2M |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 119 | $175K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 119 | $175K |
| Life insurance(4 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 139 | $76K |
| Long-term disability(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 118 | $63K |
| Prescription drug(3 contracts, 2 carriers) | UNITEDHEALTHCARE INSURANCE COMPANY | 133 | $2.2M |
| Other(7 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 139 | $260K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 139 | — |
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.