| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| SBR SERVICES LLC3 | 2300 WINDY RIDGEPARKWAY, SUITE 695S ATLANTA, GA 30339 | SYMETRA LIFE INSURANCE COMPANY | $0 | $23K | $23K | 6.89% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NW LLC | PO BOX 3018 BOTHELL, WA 98011 | SYMETRA LIFE INSURANCE COMPANY | $7K | $0 | $7K | 2.09% |
| STEALTH PARTNER GROUP LLC3 | 18700 NORTH HAYDEN ROAD, SUITE 405 SCOTTSDALE, AZ 85255 | SYMETRA LIFE INSURANCE COMPANY | $0 | $2K | $2K | 0.58% |
| HEALTHCARE MANAGEMENT ADMINISTRATOR3 Filed as: HEALTHCARE MANAGEMENT ADMIN | PO BOX 85016 BELLEVUE, WA 98015 | SYMETRA LIFE INSURANCE COMPANY | $0 | -$27K | -$27K | -8.17% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHWEST LLC | 2632 SOUTH CORBIN CIRCLE GREENACRES, WA 99016 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $7K | $4K | $12K | 15.77% |
| WATCHTOWER BENEFITS, LLC3 | 227 WEST MONROE STREET, SUITE 5200 CHICAGO, IL 60606 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $1K | $1K | 1.50% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UMR EIN 39-1995276 CLAIMS PROCESSING | Claims processing Service code 12 | — | $54K |
| HUB INTERNATIONAL NORTHWEST LLC EIN 91-2036015 BROKER | Other commissions Service code 55 | — | $30K |
| MOSS ADAMS LLP EIN 91-0189318 AUDITOR | Accounting (including auditing) Service code 10 | — | $29K |
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 | 137 | 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) | 137 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 137 | $74K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 137 | $74K |
| Stop-loss / reinsurancereinsurance | SYMETRA LIFE INSURANCE COMPANY | 0 | $332K |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 137 | $74K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 137 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.