| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | PO BOX 2158 RIVERSIDE, CA 92516 | PREMERA BLUE CROSS | $33K | $5K | $37K | 4.58% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | PO BOX 3018 BOTHELL, WA 98041 | USABLE LIFE | $3K | — | $3K | 12.85% |
| CONNEXION INSURANCE SOLUTIONS3 Filed as: CONNEXION INSURANCE SOLUTIONS, INC. | PO BOX 34315 SEATTLE, WA 98124 | USABLE LIFE | $2K | — | $2K | 9.72% |
| EMSPRING CORPORATION3 | 3911 CASTLEVALE ROAD, SUITE 209 YAKIMA, WA 98902 | USABLE LIFE | $161 | — | $161 | 0.78% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | PO BOX 749083 LOS ANGELES, CA 90074 | VISION SERVICE PLAN | $372 | — | $372 | 8.91% |
| EMSPRING CORPORATION3 | 3911 CASTLEVALE ROAD, SUITE 209 YAKIMA, WA 98902 | VISION SERVICE PLAN | $45 | — | $45 | 1.08% |
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 | 113 | 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) | 113 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | PREMERA BLUE CROSS | 66 | $813K |
| Dental | PREMERA BLUE CROSS | 66 | $813K |
| Vision | VISION SERVICE PLAN | 60 | $4K |
| Life insurance | USABLE LIFE | 113 | $21K |
| Prescription drug | PREMERA BLUE CROSS | 66 | $813K |
| Other | USABLE LIFE | 113 | $21K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 113 | — |
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.
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.