| 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 | 3.98% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHWEST LLC | PO BOX 3018 BOTHELL, WA 98041 | METROPOLITAN LIFE INSURANCE COMPANY | $1K | $691 | $2K | 9.05% |
| USI INSURANCE SERVICES LLC3 Filed as: KIBBLE & PRENTICE HOLDING COMPANY | 601 UNION STREET SEATTLE, WA 98101 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $270 | $0 | $270 | 3.39% |
| CALEB ANTHONY LAW3 | 19807 2ND DRIVE SE BOTHELL, WA 98012 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $153 | $0 | $153 | 1.92% |
| ACRIALPS LLC3 | UNKNOWN GRAND RAPIDS, MI 49501 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $104 | $35 | $139 | 1.74% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHWEST LLC | PO BOX 3018 BOTHELL, CA 98041 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $119 | $0 | $119 | 1.49% |
| MJ INSURANCE3 Filed as: BRIAN E. KROK AND VARIOUS AGENTS | 104 CAPETOWN COURT, SUITE 104 WEAVERVILLE, NC 28787 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $88 | $19 | $107 | 1.34% |
| BRIAN T MURPHY LLC3 Filed as: BRIAN T. MURPHY LLC | 5002 47TH AVENUE SW SEATTLE, WA 98136 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $68 | $0 | $68 | 0.85% |
| 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 | $56 | $0 | $56 | 0.70% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHWEST LLC | PO BOX 3018 BOTHELL, CA 98041 | VISION SERVICE PLAN | $658 | $0 | $658 | 8.34% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHWEST LLC | PO BOX 749083 LOS ANGELES, CA 90074 | VISION SERVICE PLAN | $380 | $0 | $380 | 4.82% |
| GIS NATIONAL3 Filed as: GIS NORTHERN CALIFORNIA | 315 MONTGOMERY STREET, SUITE 900 SAN FRANCISCO, CA 94104 | METLIFE LEGAL PLANS | $540 | $0 | $540 | 14.94% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHWEST LLC | PO BOX 3144 SPOKANE, WA 99220 | METLIFE LEGAL PLANS | $489 | $0 | $489 | 13.53% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS3 Filed as: BOON-CHAPMAN BENEFIT ADMIN., INC. | PO BOX 9201 AUSTIN, TX 78766 | METLIFE LEGAL PLANS | $0 | $251 | $251 | 6.95% |
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 | 134 | 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) | 134 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON | 109 | $657K |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 143 | $19K |
| Vision | VISION SERVICE PLAN | 94 | $8K |
| Life insurance(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 143 | $27K |
| Short-term disability | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 20 | $8K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON | 109 | $657K |
| Other(3 contracts, 3 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 143 | $31K |
| 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.