| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHWEST LLC | PO BOX 3018 BOTHELL, WA 98041 | UNITED HEALTHCARE INSURANCE COMPANY | $47K | $0 | $47K | 3.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | UNKNOWN CHEWELAH, WA 99109 | DELTA DENTAL OF WASHINGTON | $6K | $0 | $6K | 5.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHWEST LLC | 12100 NE 195TH STREET, SUITE 200 BOTHELL, WA 98041 | USABLE LIFE | $6K | $250 | $6K | 15.80% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHWEST LLC | 600 UNIVERSITY STREET, SUITE 1720 SEATTLE, WA 98101 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $5K | $2K | $7K | 17.53% |
| WATCHTOWER BENEFITS, LLC3 | 2734 NORTH MILDRED AVENUE, #3 CHICAGO, IL 60618 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $571 | $0 | $571 | 1.50% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHWEST LLC | PO BOX 3018 BOTHELL, WA 98041 | VISION SERVICE PLAN | $695 | $0 | $695 | 5.00% |
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 | 170 | 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) | 170 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITED HEALTHCARE INSURANCE COMPANY | 262 | $1.6M |
| Dental | DELTA DENTAL OF WASHINGTON | 157 | $112K |
| Vision | VISION SERVICE PLAN | 155 | $14K |
| Life insurance | USABLE LIFE | 170 | $41K |
| Prescription drug | UNITED HEALTHCARE INSURANCE COMPANY | 262 | $1.6M |
| Other(2 contracts, 2 carriers) | USABLE LIFE | 170 | $79K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 262 | — |
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.