| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHEAST LLC | PO BOX 3018 BOTHELL, WA 98041 | PRINCIPAL LIFE INSURANCE COMPANY | $10K | $0 | $10K | 5.27% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL LIMITED | 150 NORTH RIVERSIDE PLAZA SUITE 1700 CHICAGO, IL 60606 | PRINCIPAL LIFE INSURANCE COMPANY | $0 | $4K | $4K | 2.39% |
| WORKSITE BENEFITS GROUP INC3 Filed as: WORKSITE BENEFITS GROUP & AGENTS | 112 NORTHWEST 114TH STREET VANCOUVER, WA 98685 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4K | $1K | $6K | 9.04% |
| HEARTSEASE LLC3 | 1521 NORTHEAST 63RD AVENUE HILLSBORO, OR 97124 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3K | $2K | $5K | 7.83% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHEAST LLC | PO BOX 2158 RIVERSIDE, CA 92516 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3K | $0 | $3K | 4.30% |
| WEST COAST INSURANCE SERVICES INC3 | C/O WEST COAST INSURANCE VANCOUVER, WA 98666 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $14 | $2K | 3.09% |
| BENEFITS BY DESIGN INC3 | 2101 NORTHEAST 279TH STREET RIDGEFIELD, WA 98642 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $501 | $2K | 3.07% |
| ISAACSON INSURANCE AGENCY LLC3 | 1250 11TH STREET WEST LINN, OR 97068 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $398 | $2K | 3.03% |
| ROXANA BUSCHMAN3 | 400 NORTHEAST 149TH STREET VANCOUVER, WA 98685 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $92 | $2K | 2.51% |
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 | 135 | 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) | 135 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 414 | $182K |
| Vision | PRINCIPAL LIFE INSURANCE COMPANY | 414 | $182K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 414 | $182K |
| Short-term disability | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 88 | $62K |
| Other | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 88 | $62K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 414 | — |
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."
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.