| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | PO BOX 3018 BOTHELL, WA 98041 | UNITEDHEALTHCARE INSURANCE COMPANY | $60K | $342 | $60K | 4.02% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | 415 NORTH 2ND STREET YAKIMA, WA 98901 | AETNA LIFE INSURANCE COMPANY | $7K | $573 | $7K | 4.33% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | PO BOX 3018 BOTHELL, WA 98041 | AETNA LIFE INSURANCE COMPANY | — | $139 | $139 | 0.08% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | PO BOX 717 PULLMAN, WA 99163 | HARTFORD LIFE AND ACCIDENT | $9K | — | $9K | 14.87% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF, SEIBELS AND WILLIAMS, INC. | 1800 SOUTHWEST 1ST AVENUE SUITE 400 PORTLAND, OR 97201 | HARTFORD LIFE AND ACCIDENT | $81 | — | $81 | 0.13% |
| PAUL LANGAS3 | 700 NORTH HAYDEN ISLAND DRIVE SUITE 220 PORTLAND, OR 97217 | AFLAC | $3K | $304 | $3K | 12.04% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | 415 NORTH 2ND STREET, SUITE A YAKIMA, WA 98901 | AFLAC | $3K | — | $3K | 10.85% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF, SEIBLES AND WILLIAMS, INC. | 818 TOWN AND COUNTRY BOULEVARD SUITE 500 HOUSTON, TX 77024 | AFLAC | $345 | — | $345 | 1.35% |
| BRANDON ULESTAD3 | 404 SW 11TH STREET BATTLEGROUND, WA 98604 | AFLAC | $308 | $5 | $313 | 1.23% |
| DEREK SOMMERS3 | 518 NORTH 39TH PLACE RIDGEFIELD, WA 98642 | AFLAC | $245 | — | $245 | 0.96% |
| MATTHEW G BERGER3 Filed as: MATTHEW A. BUMALA | 14415 NW 25TH COURT VANCOUVER, WA 98685 | AFLAC | $170 | $51 | $221 | 0.87% |
| MJ INSURANCE3 Filed as: MICHAEL L. ALLEY AND VARIOUS AGENTS | 5200 MEADOWS ROAD, SUITE 150 LAKE OSWEGO, OR 97035 | AFLAC | $191 | — | $191 | 0.75% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | PO BOX 749083 LOS ANGELES, CA 90074 | VISION SERVICE PLAN | $1K | — | $1K | 5.16% |
| KEVIN C DUNN4 Filed as: KEVIN C. DUNN | 4120 NORTH FERDINAND STREET TACOMA, WA 98407 | PRE-PAID LEGAL SERIVCES, INC. DBA LEGALSHIELD | $930 | — | $930 | 22.41% |
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 | 193 | 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) | 193 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITEDHEALTHCARE INSURANCE COMPANY | 312 | $1.5M |
| Dental | AETNA LIFE INSURANCE COMPANY | 326 | $164K |
| Vision | VISION SERVICE PLAN | 149 | $20K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 113 | $62K |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 113 | $62K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 113 | $62K |
| Prescription drug | UNITEDHEALTHCARE INSURANCE COMPANY | 312 | $1.5M |
| Other(3 contracts, 3 carriers) | HARTFORD LIFE AND ACCIDENT | 113 | $92K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 326 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.