| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHWEST, LLC | PO BOX 3018 BOTHELL, WA 98041 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $12K | $0 | $12K | 8.15% |
| CAPITAL BENEFIT SERVICES, INC.3 | 15375 SE30TH PLACE, SUITE 380 BELLEVUE, WA 98007 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $632 | $0 | $632 | 0.42% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHWEST, LLC | PO BOX 3018 BOTHELL, WA 98041 | PRINCIPAL LIFE INSURANCE COMPANY | $7K | $0 | $7K | 12.68% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL LIMITED | 150 NORTH RIVERSIDE PLAZA SUITE 1700 CHICAGO, IL 60606 | PRINCIPAL LIFE INSURANCE COMPANY | $0 | $1K | $1K | 2.04% |
| RICH IN BENEFITS INC3 Filed as: RICH IN BENEFITS, INC. | 13109 NE 123RD STREET KIRKLAND, WA 98034 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $477 | $139 | $616 | 3.60% |
| ANTONIO JOSE ANGELES3 Filed as: ANTONIO MICHAEL JAIME | 24345 252ND AVENUE SE MAPLE VALLEY, WA 98038 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $606 | $0 | $606 | 3.54% |
| DEBORAH VIESELMEYER & OTHER AGENTS3 Filed as: DEBORAH DENISE VIESSELMEYER | 14405 115TH AVENUE COURT EAST PUYALLUP, WA 98374 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $240 | $89 | $329 | 1.92% |
| MEGAN ELIZABETH CASTO3 | UNKNOWN COLUMBIA, SC 29202 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $123 | $70 | $193 | 1.13% |
| DOUGLAS-MCCARTY INSURANCE SERVICES3 Filed as: DOUGLAS EDWARD VIESELMEYER | 14405 115TH AVENUE COURT EAST PUYALLUP, WA 98374 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $144 | $43 | $187 | 1.09% |
| ROBERT WILLIAM PLATTE3 | 15221 227TH AVENUE NE WOODINILLE, WA 98077 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $153 | $0 | $153 | 0.89% |
| MJ INSURANCE3 Filed as: RONALD JONES AND VARIOUS AGENTS | 320 NANCY COURT MOSCO, ID 83843 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $66 | $0 | $66 | 0.39% |
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 | 274 | 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) | 274 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance(2 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 274 | $205K |
| Short-term disability | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 233 | $17K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 274 | $149K |
| Other(2 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 274 | $205K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 274 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.