| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NW LLC-ARGUS | — | DELTA DENTAL | $21K | — | $21K | 5.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHWEST LLC | SUITE 3018 BOTHELL, WA 98041 | UNUM LIFE INSURANC COMPANY OF AMERICA | $9K | $2K | $11K | 6.24% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST LTD | EMPLOYEE BENEFITS DEPT 55 E JACKSON BLVD #14A CHICAGO, IL 60604 | UNUM LIFE INSURANC COMPANY OF AMERICA | $0 | $0 | $0 | 0.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NW LLC-ARGUS | PO BOX 749083 LOS ANGELES, CA 90074 | VISION SERVICE PLAN | $2K | — | $2K | 3.67% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NW LLC | STE 3018 BOTHELL, WA 98041 | PROVIDENT LIFE & ACCIDENT INSURANCE COMPANY | $551 | — | $551 | 1.86% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NW LLC-MOSES LAKE | PO BOX 2158 RIVERSIDE, CA 92516 | LIFEWISE ASSURANCE COMPANY | — | $50K | $50K | — |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NW LLC-MOSES LAKE | PO BOX 2158 RIVERSIDE, CA 92516 | PREMERA BLUE CROSS | $39K | $3K | $42K | — |
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 | 329 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 8 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 338 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | PREMERA BLUE CROSS | 325 | $0 |
| Dental | DELTA DENTAL | 331 | $416K |
| Vision | VISION SERVICE PLAN | 334 | $52K |
| Life insurance | UNUM LIFE INSURANC COMPANY OF AMERICA | 344 | $171K |
| Short-term disability(2 contracts, 2 carriers) | UNUM LIFE INSURANC COMPANY OF AMERICA | 344 | $201K |
| Long-term disability | UNUM LIFE INSURANC COMPANY OF AMERICA | 344 | $171K |
| Prescription drug | PREMERA BLUE CROSS | 325 | $0 |
| Stop-loss / reinsurancereinsurance | LIFEWISE ASSURANCE COMPANY | 325 | $0 |
| Other | PROVIDENT LIFE & ACCIDENT INSURANCE COMPANY | 98 | $30K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 344 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.