| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHWEST LLC | PO BOX X BELLINGHAM, WA 98227 | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON | $26K | $0 | $26K | 3.97% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHWEST LLC | PO BOX 3018 BOTHELL, CA 98041 | METROPOLITAN LIFE INSURANCE COMPANY | $3K | $45 | $3K | 5.25% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | PO BOX 2158 RIVERSIDE, CA 92516 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $1K | $1K | 2.34% |
| USI INSURANCE SERVICES LLC3 Filed as: KIBBLE AND PRENTICE HOLDING COMPANY | 601 UNION STREET SEATTLE, WA 98101 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $288 | $0 | $288 | 3.42% |
| CALEB ANTHONY LAW3 | 19807 2ND DRIVE SOUTHEAST BOTHELL, WA 98012 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $172 | $0 | $172 | 2.04% |
| BRIAN T MURPHY LLC3 Filed as: BRIAN T. MURPHY LLC | 5002 47TH AVENUE SOUTHWEST SEATTLE, WA 98136 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $83 | $0 | $83 | 0.98% |
| JOEL N NEWMAN AGENCY LLC3 Filed as: JOEL N. NEWMAN AGENCY LLC | 924-B NORTHWEST 52ND STREET SEATTLE, WA 98107 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $62 | $0 | $62 | 0.74% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHWEST LLC | PO BOX 3018 BOTHELL, CA 98041 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $24 | $0 | $24 | 0.28% |
| LAURABETH CHRISTENSEN3 | 16915 SOUTHEAST 272ND STREET KENT, WA 98042 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $21 | $0 | $21 | 0.25% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHWEST LLC | PO BOX 3018 BOTHELL, CA 98041 | VISION SERVICE PLAN | $639 | $0 | $639 | 8.18% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHWEST LLC | PO BOX 749083 LOS ANGELES, CA 90074 | VISION SERVICE PLAN | -$380 | $0 | -$380 | -4.86% |
| GIS NATIONAL3 Filed as: GIS NORTHERN CALIFORNIA | 315 MONTGOMERY STREET, SUTIE 900 SAN FRANCISCO, CA 94104 | METLIFE LEGAL PLANS | $677 | $0 | $677 | 8.74% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHWEST LLC | PO BOX 3144 SPOKANE, WA 99220 | METLIFE LEGAL PLANS | $614 | $0 | $614 | 7.92% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS3 Filed as: BOON-CHAPMAN BENEFIT ADMIN., INC. | PO BOX 9201 BUILDING 1, SUITE 100 AUSTIN, TX 78766 | METLIFE LEGAL PLANS | $0 | $315 | $315 | 4.07% |
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 | 110 | 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) | 110 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON | 90 | $650K |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 143 | $63K |
| Vision | VISION SERVICE PLAN | 85 | $8K |
| Life insurance(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 143 | $72K |
| Short-term disability | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 18 | $8K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON | 90 | $650K |
| Other(3 contracts, 3 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 143 | $79K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 143 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.