| 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 | $60K | $4K | $64K | 7.42% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHWEST LLC | 12100 NE 195TH STREET, SUITE 200 BOTHELL, WA 98011 | CONTINENTAL AMERICAN INSURANCE COMPANY | $5K | $0 | $5K | 15.44% |
| KEVIN FONSECA3 | 1413 MARSH ROAD YAKIMA, WA 98901 | CONTINENTAL AMERICAN INSURANCE COMPANY | $3K | $0 | $3K | 9.89% |
| MICHAEL D SCHULTZ3 Filed as: MICHAEL T. PETTERSON | 2807 WEST WASHINGTON AVENUE SUITE 107 YAKIMA, WA 98908 | CONTINENTAL AMERICAN INSURANCE COMPANY | $2K | $0 | $2K | 7.77% |
| KYONG H. GOINS3 | 2931 1ST AVENUES, SUITE A SEATTLE, WA 98134 | CONTINENTAL AMERICAN INSURANCE COMPANY | $669 | $0 | $669 | 2.17% |
| DAVID JOSHUA ABDELAZIZ3 Filed as: DAVID J. ABDELAZIZ | 6404 DODGER DRIVE PASCO, WA 99301 | CONTINENTAL AMERICAN INSURANCE COMPANY | $608 | $0 | $608 | 1.97% |
| DAVIS ROJAS3 | 169 EAGLE RIDGE DRIVE EAST PUYALLOP, WA 98374 | CONTINENTAL AMERICAN INSURANCE COMPANY | $544 | $0 | $544 | 1.77% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHWEST LLC | PO BOX 3018 BOTHELL, WA 98041 | VISION SERVICE PLAN | $438 | $0 | $438 | 10.96% |
| WATCHTOWER BENEFITS, LLC3 Filed as: WATCHTOWER TECHNOLOGIES INC | 306 WEST ERIE STREET, SUITE 300 CHICAGO, IL 60654 | VISION SERVICE PLAN | $24 | $0 | $24 | 0.60% |
| TOTAL BENEFIT SOLUTIONS3 | 3911 CASTLEVALE ROAD, SUITE 105 YAKIMA, WA 98902 | VISION SERVICE PLAN | $0 | $0 | $0 | 0.00% |
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 | 200 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 202 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | PREMERA BLUE CROSS | 292 | $868K |
| Dental | PREMERA BLUE CROSS | 292 | $868K |
| Vision | VISION SERVICE PLAN | 36 | $4K |
| Life insurance | CONTINENTAL AMERICAN INSURANCE COMPANY | 108 | $31K |
| Short-term disability | CONTINENTAL AMERICAN INSURANCE COMPANY | 108 | $31K |
| Prescription drug | PREMERA BLUE CROSS | 292 | $868K |
| Other | CONTINENTAL AMERICAN INSURANCE COMPANY | 108 | $31K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 292 | — |
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.