| 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 | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON OPTIONS, INC. | $28K | $0 | $28K | 5.64% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHWEST LLC | PO BOX 3018 BOTHELL, WA 98041 | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON | $2K | $0 | $2K | 5.50% |
| ARGUS BENEFITS3 Filed as: ARGUS INSURANCE | PO BOX 3018 BOTHELL, WA 98041 | PRINCIPAL LIE INSURANCE COMPANY | $4K | $0 | $4K | 8.60% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL LIMITED | 300 NORTH LA SALLE DRIVE 17TH FLOOR CHICAGO, IL 60654 | PRINCIPAL LIE INSURANCE COMPANY | $0 | $336 | $336 | 0.82% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHWEST LLC | PO BOX 3018 BOTHELL, WA 98041 | WILLAMETTE DENTAL OF WASHINGTON, INC. | $2K | $0 | $2K | 5.00% |
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 | 101 | 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) | 101 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON OPTIONS, INC. | 149 | $541K |
| Dental(2 contracts, 2 carriers) | PRINCIPAL LIE INSURANCE COMPANY | 150 | $79K |
| Vision(3 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON OPTIONS, INC. | 150 | $582K |
| Life insurance | PRINCIPAL LIE INSURANCE COMPANY | 150 | $41K |
| Prescription drug(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON OPTIONS, INC. | 149 | $541K |
| Other | PRINCIPAL LIE INSURANCE COMPANY | 150 | $41K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 150 | — |
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.