| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CONNEXION INSURANCE SOLUTIONS3 Filed as: CONNEXION INSURANCE SOLUTIONS INC | 9725 3RD AVENUE NE, SUITE 110 SEATTLE, WA 98115 | PRINCIPAL LIFE INSURANCE COMPANY | $0 | $4K | $4K | 4.27% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHWEST LLC | PO BOX 3018 BOTHELL, WA 98041 | PRINCIPAL LIFE INSURANCE COMPANY | $3K | $0 | $3K | 3.09% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL LIMITED | 150 NORTH RIVERSIDE PLAZA SUITE 1700 CHICAGO, IL 60606 | PRINCIPAL LIFE INSURANCE COMPANY | $0 | $2K | $2K | 2.46% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHWEST LLC | 12100 NORTHEAST 195TH STREET SUITE 200 BOTHELL, WA 98011 | PRINCIPAL LIFE INSURANCE COMPANY | $2K | $0 | $2K | 1.90% |
| WATCHTOWER BENEFITS, LLC3 | 306 WEST ERIE STREET, SUITE 300 CHICAGO, IL 60654 | PRINCIPAL LIFE INSURANCE COMPANY | $0 | $1K | $1K | 1.38% |
| MICHAEL D SCHULTZ3 Filed as: MICHAEL T. PETTERSON | 2807 WEST WASHINGTON AVENUE SUITE 107 YAKIMA, WA 98908 | CONTINENTAL AMERICAN INSURANCE COMPANY | $315 | $0 | $315 | 4.83% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHWEST LLC | 12100 NORTHEAST 195TH STREET SUITE 200 BOTHELL, WA 98011 | CONTINENTAL AMERICAN INSURANCE COMPANY | $309 | $0 | $309 | 4.74% |
| JENIFER L. BUSEY3 | 11 PERHAM LOOP ROAD SELAH, WA 98942 | CONTINENTAL AMERICAN INSURANCE COMPANY | $98 | $0 | $98 | 1.50% |
| KYONG H. GOINS3 Filed as: KYONG HIU GOINS | 7711 27TH AVENUE SW SEATTLE, WA 98126 | CONTINENTAL AMERICAN INSURANCE COMPANY | $92 | $0 | $92 | 1.41% |
| DAVID JOSHUA ABDELAZIZ3 | 6404 DODGER DRIVE PASCO, WA 99301 | CONTINENTAL AMERICAN INSURANCE COMPANY | $49 | $0 | $49 | 0.75% |
| MJ INSURANCE3 Filed as: GERALD INGRAHAM & VARIOUS AGENTS | 6 SOUTH 2ND STREET, SUITE 718 YAKIMA, WA 98901 | CONTINENTAL AMERICAN INSURANCE COMPANY | $16 | $0 | $16 | 0.25% |
| MICHAEL D SCHULTZ3 Filed as: MICHAEL T. PETTERSON | 203 NORTH CENTENNIAL STREET MOXEE, WA 98936 | AFLAC | $168 | $2 | $170 | 11.29% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHWEST LLC | 3911 CASTLEVALE ROAD, SUITE 209 YAKIMA, WA 98902 | AFLAC | $67 | $0 | $67 | 4.45% |
| MJ INSURANCE3 Filed as: SEAN HARRINGTON & VARIOUS AGENTS | 11151 MIERAS ROAD YAKIMA, WA 98901 | AFLAC | $58 | $0 | $58 | 3.85% |
| JENIFER L. BUSEY3 | 11 PERHAM LOOP SELAH, WA 98942 | AFLAC | $36 | $9 | $45 | 2.99% |
| DAVID JOSHUA ABDELAZIZ3 | 6404 DODGER DRIVE PASCO, WA 99301 | AFLAC | $34 | $2 | $36 | 2.39% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHWEST LLC | 415 NORTH 2ND STREET SUITE A YAKIMA, WA 98901 | AFLAC | $23 | $0 | $23 | 1.53% |
| MELISSA PAUL3 | PO BOX 8010 YAKIMA, WA 98908 | AFLAC | $20 | $0 | $20 | 1.33% |
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 | 113 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 23 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 137 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental(2 contracts, 2 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 228 | $91K |
| Vision | AFLAC | 3 | $2K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 228 | $90K |
| Short-term disability | CONTINENTAL AMERICAN INSURANCE COMPANY | 15 | $7K |
| Long-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 228 | $90K |
| Other(3 contracts, 3 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 228 | $98K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 228 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.