| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHWEST LLC | PO BOX 2158 RIVERSIDE, CA 92516 | PREMERA BLUE CROSS | $0 | $10K | $10K | 0.23% |
| THE PARTNERS GROUP3 | 11850 SW 67TH AVENUE, SUITE 100 PORTLAND, OR 97223 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $7K | $348 | $8K | 18.78% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHWEST LLC | 12100 NE 195TH STREET, SUITE 200 BOTHELL, WA 98011 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $4K | $536 | $4K | 10.13% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH AND BENEFITS | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $0 | $1K | 3.54% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHWEST LLC | 12100 NE 195TH STREET, SUITE 200 BOTHELL, WA 98011 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $556 | $556 | 3.05% |
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 | 376 | 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) | 376 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | PREMERA BLUE CROSS | 440 | $4.4M |
| Dental | PREMERA BLUE CROSS | 440 | $4.4M |
| Vision | PREMERA BLUE CROSS | 440 | $4.4M |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 376 | $18K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 376 | $18K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 376 | $18K |
| Prescription drug | PREMERA BLUE CROSS | 440 | $4.4M |
| Other(3 contracts, 3 carriers) | PREMERA BLUE CROSS | 440 | $4.5M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 440 | — |
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 comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.
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.