| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NW LLC | SUITE 3018 BOTHELL, WA 98041 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $9K | $3K | $12K | 6.29% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST LTD | EMPLOYEE BENEFITS DEPT 55 E JACKSON BLVD #14A CHICAGO, IL 60604 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | — | $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 | 3.58% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NW LLC-MOSES LAKE | PO BOX 2158 RIVERSIDE, CA 92516 | PREMERA BLUE CROSS | $41K | $2K | $43K | — |
| GAIL BERG3 Filed as: GAIL J BERG | 4190 SHORECREST DR NE MOSES LAKE, WA 98837 | AFLAC | $4K | $508 | $5K | — |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NW LLC | 415 N 2ND ST STE A YAKIMA, WA 98901 | AFLAC | $3K | $0 | $3K | — |
| SANDRA M LOHNES3 | PO BOX 678 EASTON, WA 98925 | AFLAC | $2K | $102 | $2K | — |
| LISA M HALL3 | 2542 E SUNDOWN DR COEUR D ALENE, ID 83815 | AFLAC | $922 | $102 | $1K | — |
| SANDRA J NOE3 | 2311 W 16TH AVE LOT 210 SPOKANE, WA 99224 | AFLAC | $438 | $0 | $438 | — |
| DARAN L WYCKOFF3 | 2907 E 64TH CT SPOKANE, WA 99223 | AFLAC | $203 | $0 | $203 | — |
| SEAN F HARRINGTON3 | 11151 MIERAS RD YAKIMA, WA 98901 | AFLAC | $169 | $0 | $169 | — |
| KEVIN C HALLAM3 | 5303 S BATES RD SPOKANE, WA 99206 | AFLAC | $93 | $0 | $93 | — |
| KEVIN C HALLAM3 | 2145 HYACINTH DR BILLINGS, MT 59105 | AFLAC | $68 | $0 | $68 | — |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL INC | PO BOX 203588 DALLAS, TX 75320 | AFLAC | $62 | $0 | $62 | — |
| COTTER CONSULTING & BENEFITS INC3 | 13526 160TH AVE NE REDMOND, WA 98052 | AFLAC | $60 | $0 | $60 | — |
| MICHAEL D SCHULTZ3 Filed as: MICHAEL T PETTERSON | PO BOX 3 MOXEE, WA 98936 | AFLAC | $36 | $0 | $36 | — |
| NANCY LAPHAM3 Filed as: NANCY L WALDNER | 227 BELLEVUE WAY NE APT 365 BELLEVUE, WA 98004 | AFLAC | $34 | $0 | $34 | — |
| DAVID E CIAMPOLI3 | 1204 BIG OAK DR ALMA, AR 72921 | AFLAC | $28 | $0 | $28 | — |
| CLIFF HARRISON BARROWS3 | 5716 S FERRALL ST SPOKANE, WA 99223 | AFLAC | $27 | $0 | $27 | — |
| MARY POHLMAN3 | 6102 90TH AVE SE MERCER ISLAND, WA 98040 | AFLAC | $19 | $0 | $19 | — |
| KRISTEN SUE PLAISANCE3 | 11315 E 12TH AVE SPOKANE VALLEY, WA 99206 | AFLAC | $18 | $0 | $18 | — |
| BRIAN W. BALMES3 Filed as: BRIAN W BALMES | 302 S 1ST ST YAKIMA, WA 98901 | AFLAC | $9 | $0 | $9 | — |
| KRISTINE G WYCKOFF3 | PO BOX 31233 SPOKANE, WA 99223 | AFLAC | $9 | $0 | $9 | — |
| COREY H ROWLES3 | 24417 SE 127TH ST ISSAQUAH, WA 98027 | AFLAC | $6 | $0 | $6 | — |
| CRAIG A HANSEN3 | 6848 RIVERDALE DR SE TUMWATER, WA 98501 | AFLAC | $4 | $0 | $4 | — |
| SUWAT ASSAWAMATIYANONT3 | 8171 HAMPTON WOOD DR BOCA RATON, FL 33433 | AFLAC | $3 | $0 | $3 | — |
| DIXIE D SIMON3 | 509 N SHAMROCK RD SPOKANE VALLEY, WA 99037 | AFLAC | $3 | $0 | $3 | — |
| SCOTT W BLACKSHEAR3 | 3453 CATHRYN DR COLUMBUS, GA 31906 | AFLAC | $3 | $0 | $3 | — |
| DAVID J MCCLELLAN3 Filed as: DAVID JOHN HANNANT | 14830 NE 167TH ST WOODINVILLE, WA 98072 | AFLAC | $2 | $0 | $2 | — |
| MICHAEL C WALKER3 Filed as: MICHAEL A STACHOWIAK | 321 N CLARK ST STE 625 CHICAGO, IL 60654 | AFLAC | $2 | $0 | $2 | — |
| JOSHUA PAUL GROUP INC3 Filed as: JOSHUA M HELDEROP | 10509 NE 120TH PL KIRKLAND, WA 98034 | AFLAC | $2 | $0 | $2 | — |
| MICHAEL C WALKER3 Filed as: MICHAEL A STACHOWIAK | 321 N CLARK ST STE 615 CHICAGO, IL 60654 | AFLAC | $1 | $0 | $1 | — |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NW LLC-MOSES LAKE | PO BOX 2158 RIVERSIDE, CA 925162158 | LIFEWISE ASSURANCE COMPANY | $33K | $48K | $81K | — |
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 | 345 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 10 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 357 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | PREMERA BLUE CROSS | 427 | $0 |
| Dental | DELTA DENTAL | 913 | $431K |
| Vision | VISION SERVICE PLAN | 351 | $54K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 363 | $196K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 363 | $196K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 363 | $196K |
| Prescription drug | PREMERA BLUE CROSS | 427 | $0 |
| Stop-loss / reinsurancereinsurance | LIFEWISE ASSURANCE COMPANY | 348 | $0 |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 913 | — |
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.