| 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 | PREMERA BLUE CROSS | $59K | $7K | $66K | 5.64% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHWEST LLC | UNKNOWN YAKIMA, WA 98902 | WILLAMETTE DENTAL OF WASHINGTON, INC. | $4K | $0 | $4K | 4.53% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHWEST LLC | PO BOX 3018 BOTHELL, WA 98041 | METROPOLITAN LIFE INSURANCE COMPANY | $3K | $482 | $3K | 6.86% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHWEST LLC | PO BOX 3018 BOTHELL, WA 98041 | VISION SERVICE PLAN | $466 | $0 | $466 | 9.34% |
| TOTAL BENEFIT SOLUTIONS3 | 3911 CASTLEVALE ROAD, SUITE 105 YAKIMA, WA 98902 | VISION SERVICE PLAN | $466 | $0 | $466 | 9.34% |
| MICHAEL PETTERSON3 | 203 NORTH CENTENNIAL STREET MOXEE, WA 98936 | AFLAC | $76 | $0 | $76 | 6.14% |
| MJ INSURANCE3 Filed as: KYONG GOINS & VARIOUS AGENTS | 7711 27TH AVENUE SW SEATTLE, WA 98126 | AFLAC | $47 | $0 | $47 | 3.80% |
| PHILBERT E ORTEGA3 Filed as: PHILBERT ORTEGA | 15100 SOUTHEAST 38TH STREET SUITE 763 BELLEVUE, WA 98006 | AFLAC | $20 | $0 | $20 | 1.62% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHWEST LLC | 415 NORTH 2ND STREET SUITE A YAKIMA, WA 98901 | AFLAC | $11 | $0 | $11 | 0.89% |
| SEAN F HARRINGTON3 Filed as: SEAN HARRINGTON | 11151 MIERAS ROAD YAKIMA, WA 98901 | AFLAC | $10 | $0 | $10 | 0.81% |
| MELISSAS PAUL3 | PO BOX 8010 YAKIMA, WA 98908 | AFLAC | $8 | $0 | $8 | 0.65% |
| ROSIO PEREZ3 | 21 CODY LANE SUNNYSIDE, WA 98944 | AFLAC | $8 | $0 | $8 | 0.65% |
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 | 186 | 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) | 186 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | PREMERA BLUE CROSS | 129 | $1.2M |
| Dental(2 contracts, 2 carriers) | WILLAMETTE DENTAL OF WASHINGTON, INC. | 165 | $133K |
| Vision | VISION SERVICE PLAN | 45 | $5K |
| Life insurance | AFLAC | 186 | $1K |
| Short-term disability | AFLAC | 186 | $1K |
| Prescription drug | PREMERA BLUE CROSS | 129 | $1.2M |
| Other | AFLAC | 186 | $1K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 186 | — |
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.