| 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 | $31K | $0 | $31K | 5.43% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHWEST LLC | 415 NORTH 2ND STREET YAKIMA, WA 98901 | DELTA DENTAL OF WASHINGTON | $4K | $0 | $4K | 5.20% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHWEST LLC | 12100 NORTHEAST 195TH STREET SUITE 200 BOTHELL, WA 98011 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $489 | $0 | $489 | 4.32% |
| CONOVER INSURANCE SERVICES LLC3 | PO BOX 10088 YAKIMA, WA 98909 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $404 | $0 | $404 | 3.57% |
| GREYHAVENS CONSULTING LLC3 | 1313 EAST MAPLE STREET BELLINGHAM, WA 98225 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $290 | $0 | $290 | 2.56% |
| VALORIE L STRICKLAND3 Filed as: VALORIE L. STRICKLAND | 1437 CIMARRON PLACE RICHLAND, WA 99352 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $190 | $0 | $190 | 1.68% |
| MJ INSURANCE3 Filed as: BENEFITS BY DESIGN & VARIOUS AGENTS | 2101 NORTHEAST 279TH STREET RIDGEFIELD, WA 98642 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $126 | $5 | $131 | 1.16% |
| LUANN E DAVIS3 Filed as: LUANN E. DAVIS | 325 NORTH GRANT STREET KENNEWICK, WA 99336 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $65 | $0 | $65 | 0.57% |
| JESSICA LOREE GROW3 | 10 SOUTH VANCOUVER STREET KENNEWICK, WA 99336 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $41 | $2 | $43 | 0.38% |
| TRICIA CHARLES3 | 615 SOUTH 48TH AVENUE, SUITE B YAKIMA, WA 98908 | AFLAC | $697 | $68 | $765 | 8.48% |
| GERALD INGRAHAM3 | PO BOX 133 MOXEE, WA 98936 | AFLAC | $162 | $17 | $179 | 1.98% |
| JUANITA K. ACOB3 | 1317 SOUTH 21ST AVENUE, SUITE 1 YAKIMA, WA 98902 | AFLAC | $139 | $17 | $156 | 1.73% |
| MICHAEL A MAYER3 Filed as: MICHAEL A. MAYER | 4406 CAMPOLINA LANE PASCO, WA 99301 | AFLAC | $106 | $17 | $123 | 1.36% |
| SANDRA L. GIRARD3 | 1116 SONORA AVENUE MANTECA, CA 95337 | AFLAC | $112 | $0 | $112 | 1.24% |
| MJ INSURANCE3 Filed as: SCOTT R. ST MARY AND VARIOUS AGENTS | 903 NORTH 34TH AVENUE SUITE 13 YAKIMA, WA 98902 | AFLAC | $70 | $0 | $70 | 0.78% |
| TERRY K ALLEN3 Filed as: TERRY K. ALLEN | 20930 EAST HAPPY TRAILS LANE OTIS ORCHARDS, WA 99027 | AFLAC | $61 | $0 | $61 | 0.68% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHWEST LLC | PO BOX 3018 BOTHELL, WA 98041 | VISION SERVICE PLAN | $679 | $0 | $679 | 7.93% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHWEST LLC | 12100 NORTHEAST 195TH STREET SUITE 200 BOTHELL, WA 98011 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $0 | $1K | 15.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHWEST LLC | PO BOX 2158 RIVERSIDE, CA 92516 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $600 | $600 | 7.77% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHWEST LLC | 415 NORTH 2ND STREET 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 | 101 | 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) | 101 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | PREMERA BLUE CROSS | 61 | $571K |
| Dental(3 contracts, 3 carriers) | PREMERA BLUE CROSS | 127 | $650K |
| Vision | VISION SERVICE PLAN | 86 | $9K |
| Life insurance(2 contracts, 2 carriers) | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 101 | $19K |
| Short-term disability(2 contracts, 2 carriers) | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 15 | $20K |
| Prescription drug | PREMERA BLUE CROSS | 61 | $571K |
| Other(4 contracts, 4 carriers) | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 167 | $32K |
| 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.