| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHWEST LLC | 12100 NE 195TH ST SUITE 200 BOTHELL, WA 98011 | SUN LIFE ASSURANCE COMPANY OF CANADA | $26K | — | $26K | 3.20% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHWEST LLC | PO BOX 3018 BOTHELL, WA 98041 | DELTA DENTAL OF WASHINGTON | $4K | — | $4K | 0.92% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHWEST LLC | 12100 NE 195TH STREET SUITE 200 BOTHELL, WA 98011 | SUN LIFE ASSURANCE COMPANY OF CANADA | $5K | — | $5K | 2.68% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHWEST LLC | 501 S BERNARD SPOKANE, WA 98204 | RELIANCE STANDARD LIFE INSURANCE | $10K | $0 | $10K | 8.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| AMERIBEN IEC GROUP TPA EIN 82-0308198 CLAIM PROCESSING / CMU | Claims processing Service code 12 | 3449 E COPPER POINT DRIVE MERIDIAN, ID 83642 | $178K |
| HUB INTERNATIONAL NORTHWEST LLC EIN 91-2036015 CONSULTANT | Consulting (general) Service code 16 | 12100 NE 195TH STREET SUITE 200 BOTHELL, WA 98011 | $66K |
| FIRST CHOICE HEALTH NETWORK EIN 91-1272766 PPO NETWORK | Other insurance fees and expenses Service code 73 | 600 UNIVERSITY STREET SUITE 1400 SEATTLE, WA 98101 | $56K |
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 | 489 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 489 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF WASHINGTON | 530 | $395K |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 535 | $177K |
| Short-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 504 | $86K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE | 54 | $120K |
| Stop-loss / reinsurancereinsurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 501 | $807K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 535 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.