| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHWEST, LLC | 12100 NE 195TH STREET SUITE 200 BOTHELL, WA 98001 | SUN LIFE ASSURANCE COMPANY OF CANADA | $19K | — | $19K | 2.32% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHWEST, LLC | PO BOX 2018 BOTHELL, WA 98041 | DELTA DENTAL OF WASHINGTON | $4K | — | $4K | 1.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHWEST, LLC | PO BOX 3018 BOTHELL, WA 98041 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $26K | $9K | $35K | 20.00% |
| HUB INTERNATIONAL MIDWEST LIMITED0 Filed as: HUB INTERNATIONAL NORTHWEST, LLC | 501 S BERNARD SUITE 200 SPOKANE, WA 99204 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $9K | $4K | $13K | 11.11% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHWEST, LLC | 501 S BERNARD SPOKANE, WA 99204 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $3K | — | $3K | 3.12% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHWEST, LLC | PO BOX 3018 BOTHELL, WA 98041 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $1K | — | $1K | 2.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| AMERIBEN IEC GROUP EIN 82-0497661 THIRD PARTY ADMINISTRATOR | Claims processing Service code 12 | PO BOX 7186 BOISE, ID 83707 | $223K |
| HUB INTERNATIONAL NORTHWEST EIN 91-2036015 CONSULTANT | Consulting (general) Service code 16 | PO BOX 3108 BOTHELL, WA 98041 | $75K |
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 | 554 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 554 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF WASHINGTON | 552 | $399K |
| Life insurance | RELIANCE STANDARD LIFE INSURANCE COMPANY | 540 | $173K |
| Short-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 533 | $83K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 533 | $115K |
| Stop-loss / reinsurancereinsurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 528 | $834K |
| Other | RELIANCE STANDARD LIFE INSURANCE COMPANY | 543 | $59K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 552 | — |
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.