| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHWEST, LLC | PO BOX 10088 YAKIMA, WA 98909 | PACIFICSOURCE HEALTH PLANS | $59K | $3K | $62K | 1.99% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHWEST, LLC | UNKNOWN PASCO, WA 99301 | DELTA DENTAL OF WASHINGTON | $4K | $0 | $4K | 2.04% |
| LOCKTON COMPANIES, LLC3 | 600 UNIVERSITY STREET, SUITE 1900 SEATTLE, WA 98101 | DELTA DENTAL OF WASHINGTON | $2K | $0 | $2K | 1.23% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHWEST, LLC | 155 108TH AVENUE NE, SUITE 275 BELLEVUE, WA 98004 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $9K | $8K | $17K | 18.10% |
| LOCKTON COMPANIES, LLC3 | 600 UNIVERSITY STREET, SUITE 1900 SEATTLE, WA 98101 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $0 | $3K | 3.12% |
| ADVANCED BENEFITS3 | UNKNOWN PASCO, WA 99301 | WILLAMETTE DENTAL OF WASHINGTON, INC. | $1K | $0 | $1K | 5.49% |
| LOCKTON COMPANIES, LLC3 | 600 UNIVERSITY STREET, SUITE 1900 SEATTLE, WA 98101 | WILLAMETTE DENTAL OF WASHINGTON, INC. | $126 | $0 | $126 | 0.51% |
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 | 268 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 6 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 274 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | PACIFICSOURCE HEALTH PLANS | 413 | $3.1M |
| Dental(2 contracts, 2 carriers) | DELTA DENTAL OF WASHINGTON | 411 | $222K |
| Vision | PACIFICSOURCE HEALTH PLANS | 413 | $3.1M |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 268 | $94K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 268 | $94K |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 268 | $94K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 413 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.