| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHWEST LLC | 12100 NORTHEAST 195TH STREET SUITE 200 BOTHELL, WA 98011 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $27K | $7K | $35K | 12.38% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHWEST LLC | 12100 NORTHEAST 195TH STREET SUITE 200 BOTHELL, WA 98011 | UNUM INSURANCE COMPANY | $6K | $1K | $7K | 13.74% |
| HODGES-MACE BENEFITS GRP INC3 Filed as: HODGES-MACE BENEFITS GROUP | 3350 RIVERWOOD PARKWAY SUITE 80 ATLANTA, GA 30339 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $533 | $0 | $533 | 2.08% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHWEST LLC | 12100 NORTHEAST 195TH STREET SUITE 200 BOTHELL, WA 98011 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $345 | $24 | $369 | 1.44% |
| AON CONSULTING INC3 Filed as: AON CONSULTING | PO BOX 905494 CHARLOTTE, NC 28290 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $219 | $6 | $225 | 0.88% |
| PIERCE, DWIGHT, L3 Filed as: PIERCE, DWIGHT, L BENEFITS TECH. | 20 WIGHT AVENUE, SUITE 160 COCKEYSVILLE, MD 21030 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $196 | $0 | $196 | 0.77% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CENTIVO EIN 81-3489510 CLAIMS ADMIN | Direct payment from the plan; Claims processing Service code 12 | — | $438K |
| HUB INTERNATIONAL EIN 75-3243028 ADVISOR | Direct payment from the plan; Claims processing Service code 12 | — | $130K |
| DELTA DENTAL EIN 91-0621480 CLAIMS PROCESSING | Direct payment from the plan; Claims processing Service code 12 | — | $33K |
| VISION SERVICE PLAN EIN 23-7089668 CLAIMS PROCESSING | Direct payment from the plan; Claims processing Service code 12 | — | $12K |
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 | 1,134 | 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) | 1,134 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,134 | $306K |
| Short-term disability(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,134 | $306K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,134 | $281K |
| Other(3 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 4,560 | $379K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 4,560 | — |
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.