| 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 | AETNA LIFE INSURANCE COMPANY | $29K | $4K | $33K | 3.51% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | 11714 NORTH CREEK PARKWAY NORTH BOTHELL, WA 98011 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $11K | — | $11K | 6.88% |
| GAIL BERG3 | 4190 SHORECREST DRIVE NE MOSES LAKE, WA 98837 | AFLAC | $2K | $39 | $2K | 4.73% |
| BRUCE J CURRIER3 Filed as: BRUCE J. CURRIER | PO BOX 3334 BELLEVUE, WA 98009 | AFLAC | $2K | $39 | $2K | 4.29% |
| MJ INSURANCE3 Filed as: BARRY E JONES AND VARIOUS AGENTS | 6573 FORZA COURT LAS VEGAS, NV 89131 | AFLAC | $775 | $15 | $790 | 2.01% |
| JANIS WEST3 | 210 DAWN CREST PLACE CAMANO ISLAND, WA 98292 | AFLAC | $330 | — | $330 | 0.84% |
| CHRISTOPHER A. BERG3 | 14220 21ST DRIVE SE MILL CREEK, WA 98012 | AFLAC | $303 | — | $303 | 0.77% |
| PAUL B ROBEDEAU3 Filed as: PAUL B. ROBEDEAU | 904 LA TERRAZA COURT MONTEREY, CA 93940 | AFLAC | $134 | — | $134 | 0.34% |
| DAVID J MCCLELLAN3 Filed as: DAVID JOHN HANNANT | 14830 NE 167TH STREET WOODINVILLE, WA 98072 | AFLAC | $84 | $16 | $100 | 0.25% |
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 | 92 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 6 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 98 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | AETNA LIFE INSURANCE COMPANY | 132 | $931K |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 100 | $160K |
| Vision | AETNA LIFE INSURANCE COMPANY | 132 | $931K |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 100 | $160K |
| Long-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 100 | $160K |
| Prescription drug | AETNA LIFE INSURANCE COMPANY | 132 | $931K |
| Other(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 100 | $200K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 132 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.