| 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 | PREMERA BLUE CROSS | $38K | $632 | $38K | 5.76% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHWEST LLC | 415 NORTH 2ND STREET YAKIMA, WA 98901 | DELTA DENTAL OF WASHINGTON | $4K | $0 | $4K | 5.32% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHWEST LLC | 12100 NE 195TH STREET, SUITE 200 BOTHELL, WA 98011 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $0 | $2K | 6.44% |
| VALORIE L STRICKLAND3 Filed as: VALORIE L. STRICKLAND | 1437 CIMARRON PLACE RICHLAND, WA 99352 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $812 | $12 | $824 | 3.45% |
| GREYHAVENS CONSULTING LLC3 | 1313 EAST MAPLE STREET BELLINGHAM, WA 98225 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $757 | $0 | $757 | 3.17% |
| CONOVER INSURANCE SERVICES LLC3 | PO BOX 10088 YAKIMA, WA 98909 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $611 | $0 | $611 | 2.56% |
| MJ INSURANCE3 Filed as: LUANN E. DAVIS AND VARIOUS AGENTS | 325 NORTH GRANT STREET KENNEWICK, WA 99336 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $435 | $83 | $518 | 2.17% |
| JESSICA LOREE GROW3 | 10 SOUTH VANCOUVER STREET KENNEWICK, WA 99336 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $185 | $47 | $232 | 0.97% |
| LAURIE C BERRY3 Filed as: LAURIE C. BERRY | 19308 CROWN RIDGE BOULEVARD ARLINGTON, WA 98223 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $120 | $24 | $144 | 0.60% |
| TRICA CHARLES3 | 615 SOUTH 48TH AVENUE, SUITE B YAKIMA, WA 98908 | AFLAC | $2K | $82 | $2K | 14.46% |
| GERALD INGRAHAM3 | 6 SOUTH 2ND STREET, SUITE 718 YAKIMA, WA 98901 | AFLAC | $491 | $20 | $511 | 4.60% |
| JUANITA K. ACOB3 | 1317 SOUTH 21ST AVEMUE, SUITE 1 YAKIMA, WA 98902 | AFLAC | $338 | $20 | $358 | 3.22% |
| MICHAEL A MAYER3 Filed as: MICHAEL A. MAYER | 4406 CAMPOLINA LANE PASCO, WA 99301 | AFLAC | $302 | $20 | $322 | 2.90% |
| SANDRA L. GIRARD3 | 1116 SONORA AVENUE MANTECA, CA 95337 | AFLAC | $121 | $0 | $121 | 1.09% |
| SCOTT R ST MARY3 Filed as: SCOTT R. SAINT MARY | 903 NORTH 34TH AVENUE TRAILER 13 YAKIMA, WA 98902 | AFLAC | $53 | $0 | $53 | 0.48% |
| MJ INSURANCE3 Filed as: DIXIE D. SIMON AND VARIOUS AGENTS | 509 NORTH SHAMROCK ROAD SPOKANE VALLEY, WA 99037 | AFLAC | $43 | $0 | $43 | 0.39% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHWEST LLC | PO BOX 749083 LOS ANGELES, CA 90074 | VISION SERVICE PLAN | $525 | $0 | $525 | 4.90% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHWEST LLC | PO BOX 3018 BOTHELL, WA 98041 | VISION SERVICE PLAN | $295 | $0 | $295 | 2.75% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHWEST LLC | PO BOX 2158 RIVERSIDE, CA 92516 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $0 | $2K | 14.99% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHWEST LLC | 12100 NE 195TH STREET, SUITE 200 BOTHELL, WA 98011 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $730 | $730 | 6.89% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 316 EAST YAKIMA, SUITE 203 YAKIMA, WA 98901 | FIRST CHOICE HEALTH | $200 | $0 | $200 | 4.99% |
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 | 65 | 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) | 65 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | PREMERA BLUE CROSS | 89 | $664K |
| Dental(3 contracts, 3 carriers) | PREMERA BLUE CROSS | 143 | $755K |
| Vision | VISION SERVICE PLAN | 91 | $11K |
| Life insurance(2 contracts, 2 carriers) | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 115 | $34K |
| Short-term disability(2 contracts, 2 carriers) | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 21 | $35K |
| Prescription drug | PREMERA BLUE CROSS | 89 | $664K |
| Other(4 contracts, 4 carriers) | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 167 | $50K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 167 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.