| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | PO BOX 2158 RIVERSIDE, CA 92615 | PREMERA BLUE CROSS | $96K | $11K | $107K | 3.75% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | 12100 NE 195TH STREET, SUITE 200 BOTHELL, WA 98011 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $15K | $5K | $21K | 12.80% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | 12100 NORTHEAST 195TH STREET SUITE 200 BOTHELL, WA 98011 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $9K | $3K | $12K | 7.31% |
| MJ INSURANCE3 Filed as: BRANDON HOOBLER AND VARIOUS AGENTS | 1230 SOUTH 336TH STREET, SUITE A FEDERAL WAY, WA 98003 | AFLAC | $3K | $111 | $4K | 6.10% |
| SUSAN WRIGHT3 | 4923 LAKERIDGE DRIVE EAST LAKE TAPPS, WA 98391 | AFLAC | $2K | $139 | $3K | 4.35% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | PO BOX 3018 BOTHELL, WA 98041 | AFLAC | $2K | $0 | $2K | 2.94% |
| BARRY G WIEBE3 Filed as: BARRY WIEBE | 5479 SUNDOWN VIEW TERRACE BELLINGHAM, WA 98226 | AFLAC | $1K | $98 | $1K | 2.50% |
| MARGARET A. TIBBITS3 Filed as: MARGARET TIBBITS | 3064 NORTHSHORE ROAD BELLINGHAM, WA 98226 | AFLAC | $1K | $0 | $1K | 2.23% |
| ANNA JANICE RUIZ3 Filed as: ANNA HOOBLER | 1230 SOUTH 336TH STREET, SUITE A FEDERAL WAY, WA 98003 | AFLAC | $835 | $28 | $863 | 1.48% |
| LISA R PETERS3 Filed as: LISA PETERS | 1932 EAST COLLEGE WAY, SUITE B MOUNT VERNON, WA 98273 | AFLAC | $555 | $19 | $574 | 0.98% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | PO BOX 749083 LOS ANGELES, CA 90074 | VISION SERVICE PLAN | $2K | $0 | $2K | 4.97% |
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 | 425 | 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) | 425 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | PREMERA BLUE CROSS | 533 | $2.9M |
| Vision | VISION SERVICE PLAN | 379 | $41K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 425 | $160K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 425 | $160K |
| Prescription drug | PREMERA BLUE CROSS | 533 | $2.9M |
| Other(3 contracts, 3 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 438 | $228K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 533 | — |
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.