| 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 | PACIFICSOURCE HEALTH PLANS | $79K | $0 | $79K | 4.94% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHWEST, LLC | PO BOX 3018 BOTHELL, WA 98041 | DELTA DENTAL OF WASHINGTON | $4K | $0 | $4K | 5.48% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHWEST, LLC | PO BOX 3144 SPOKANE, WA 99220 | SUN LIFE ASSURANCE COMPANY OF CANADA | $8K | $0 | $8K | 14.11% |
| WATCHTOWER TECHNOLOGIES INC3 Filed as: WATCHTOWER TECHNOLOGIES, INC. | 306 WEST ERIE STREET, SUITE 300 CHICAGO, IL 60654 | SUN LIFE ASSURANCE COMPANY OF CANADA | $425 | $0 | $425 | 0.73% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHWEST, LLC | PO BOX 3018 BOTHELL, WA 98041 | WILLAMETTE DENTAL OF WASHINGTON, INC. | $2K | $0 | $2K | 5.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHWEST, LLC | PO BOX 3144 SPOKANE, WA 99220 | SUN LIFE ASSURANCE COMPANY OF CANADA | $324 | $0 | $324 | 4.59% |
| WATCHTOWER TECHNOLOGIES INC3 Filed as: WATCHTOWER TECHNOLOGIES, INC. | 306 WEST ERIE STREET, SUITE 300 CHICAGO, IL 60654 | SUN LIFE ASSURANCE COMPANY OF CANADA | $107 | $0 | $107 | 1.51% |
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 | 227 | 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) | 227 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | PACIFICSOURCE HEALTH PLANS | 156 | $1.6M |
| Dental(2 contracts, 2 carriers) | DELTA DENTAL OF WASHINGTON | 110 | $115K |
| Vision | SUN LIFE ASSURANCE COMPANY OF CANADA | 223 | $58K |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 223 | $58K |
| Prescription drug | PACIFICSOURCE HEALTH PLANS | 156 | $1.6M |
| Other(3 contracts, 2 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 223 | $68K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 223 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.
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.