| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHWEST LLC | PO BOX 3018 BOTHELL, WA 98041 | PRINCIPAL LIFE INSURANCE COMPANY | $5K | — | $5K | 6.46% |
| CONNEXION INSURANCE SOLUTIONS3 Filed as: CONNEXION INSURANCE SOLUTIONS INC | 9725 3RD AVENUE NE, SUITE 110 SEATTLE, WA 98115 | PRINCIPAL LIFE INSURANCE COMPANY | — | $4K | $4K | 4.45% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL LIMITED | 150 N RIVERSIDE PLAZA SUITE 1700 CHICAGO, IL 60606 | PRINCIPAL LIFE INSURANCE COMPANY | — | $3K | $3K | 3.46% |
| WATCHTOWER BENEFITS, LLC3 | 306 WEST ERIE STREET, SUITE 300 CHICAGO, IL 60654 | PRINCIPAL LIFE INSURANCE COMPANY | — | $1K | $1K | 1.63% |
| MICHAEL D SCHULTZ3 Filed as: MICHAEL T. PETTERSON | 6334 SOMERSBY COURT NW ROCHESTER, MN 55901 | AFLAC | $2K | $10 | $2K | 32.19% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHWEST LLC | 6443 SW BEAVERTON HILLSDALE HIGHWAY SUITE 200 PORTLAND, OR 97221 | AFLAC | $457 | $0 | $457 | 9.59% |
| DAVID JOSHUA ABDELAZIZ3 | 331 SADDLE LEAF CIBOLO, TX 78108 | AFLAC | $250 | $3 | $253 | 5.31% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHWEST LLC | 3911 CASTLEVALE ROAD SUITE 209 YAKIMA, WA 98902 | AFLAC | $11 | $0 | $11 | 0.23% |
| JENIFER L. BUSEY3 Filed as: JENIFER L BUSEY | 11 PERHAM LOOP SELAH, WA 98942 | AFLAC | $5 | $4 | $9 | 0.19% |
| MICHAEL D SCHULTZ3 Filed as: MICHAEL T. PETTERSON | 6334 SOMERSBY COURT NW ROCHESTER, MN 55901 | CONTINENTAL AMERICAN INSURANCE COMPANY | $30 | $0 | $30 | 6.16% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHWEST LLC | 12100 NE 195TH, SUITE 200 BOTHELL, WA 98011 | CONTINENTAL AMERICAN INSURANCE COMPANY | $24 | $0 | $24 | 4.93% |
| JENIFER L. BUSEY3 Filed as: JENIFER L BUSEY | 11 PERHAM LOOP ROAD SELAH, WA 98942 | CONTINENTAL AMERICAN INSURANCE COMPANY | $9 | $0 | $9 | 1.85% |
| KYONG H. GOINS3 Filed as: KYONG HIU GOINS | 7711 27TH AVENUE SW SEATTLE, WA 98126 | CONTINENTAL AMERICAN INSURANCE COMPANY | $8 | $0 | $8 | 1.64% |
| DAVID JOSHUA ABDELAZIZ3 | 331 SADDLE LEAF CIBOLO, TX 78108 | CONTINENTAL AMERICAN INSURANCE COMPANY | $5 | $0 | $5 | 1.03% |
| GERALD INGRAHAM3 Filed as: GERALD OTIS INGRAHAM | 4903 BELL ROAD 6 SOUTH 2ND STREET, SUITE 718 YAKIMA, WA 98901 | CONTINENTAL AMERICAN INSURANCE COMPANY | $1 | $0 | $1 | 0.21% |
| MICHAEL A MAYER3 Filed as: MICHAEL A. MAYER | 4406 CAMPOLINA LANE PASCO, WA 99301 | CONTINENTAL AMERICAN INSURANCE COMPANY | $0 | $0 | $0 | 0.00% |
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 | 123 | 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) | 123 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental(2 contracts, 2 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 205 | $89K |
| Vision | AFLAC | 6 | $5K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 205 | $84K |
| Short-term disability | CONTINENTAL AMERICAN INSURANCE COMPANY | 6 | $487 |
| Long-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 205 | $84K |
| Other(3 contracts, 3 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 205 | $89K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 205 | — |
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.