| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHWEST | PO BOX 2158 RIVERSIDE, CA 92516 | PREMERA BLUE CROSS | $200K | $55K | $255K | 3.28% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHWEST LLC | 2632 SOUTH CORBIN CIRCLE GREENACRES, WA 99016 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $39K | $15K | $53K | 18.87% |
| WATCHTOWER BENEFITS, LLC5 | 227 WEST MONROE STREET. SUITE 5200 CHICAGO, IL 60606 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $4K | $4K | 1.50% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHWEST LLC | 12100 NE 195TH STREET, SUITE 200 BOTHELL, WA 98011 | NATIONAL UNION FIRE INSURANCE COMPANY OF PITTSBURGH, PA | $143 | $0 | $143 | 15.05% |
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 | 1,063 | 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) | 1,063 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | PREMERA BLUE CROSS | 549 | $7.8M |
| Vision | PREMERA BLUE CROSS | 549 | $7.8M |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 1,063 | $283K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 1,063 | $283K |
| Prescription drug | PREMERA BLUE CROSS | 549 | $7.8M |
| Other(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 1,063 | $284K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,063 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.