| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LARRY E VANDERPOL3 Filed as: LARRY E.VANDERPOL | 589 EAST BADGER ROAD LYNDEN, WA 98264 | AFLAC | $1K | $203 | $2K | 10.58% |
| BARRY G WIEBE3 Filed as: BARRY G. WIEBE | 647 OLD SAMISH ROAD BELLINGHAM, WA 98229 | AFLAC | $438 | $41 | $479 | 3.11% |
| MJ INSURANCE3 Filed as: LISA R. PETERS AND VARIOUS AGENTS | 1509 RIVERSIDE DRIVE SUITE A MOUNT VERNON, WA 98273 | AFLAC | $347 | $39 | $386 | 2.51% |
| BRANDON PENKO3 Filed as: BRANDON C HOOBLER | 14220 INTERURBAN AVENUE SUITE 150 SEATTLE, WA 98168 | AFLAC | $109 | $41 | $150 | 0.98% |
| LISA R PETERS3 Filed as: LISA R. PETERS | 1932 EAST COLLEGE WAY SUITE B MOUNT VERNON, WA 98273 | AFLAC | $129 | — | $129 | 0.84% |
| MICHAEL C WALKER3 Filed as: MICHAEL L ALLEY | 5200 MEADOWS ROAD, SUITE 150 LAKE OSWEGO, OR 97035 | AFLAC | $81 | — | $81 | 0.53% |
| MARGARET A. TIBBITS3 | PO BOX 32388 BELLINGHAM, WA 98228 | AFLAC | $56 | — | $56 | 0.36% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | PO BOX 3018 BOTHELL, WA 98041 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $2K | — | $2K | 13.74% |
| ALLIANT INSURANCE SERVICES, INC.3 | 1420 5TH AVENUE, SUITE 1500 SEATTLE, WA 98101 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $187 | — | $187 | 1.26% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES, INC. | 55 EAST JACKSON, SUITE 600 CHICAGO, IL 60604 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $168 | $168 | 1.13% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | PO BOX 3018 BOTHELL, WA 98041 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $260 | — | $260 | 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 | 183 | 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) | 183 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 183 | $5K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 173 | $15K |
| Other(2 contracts, 2 carriers) | AFLAC | 183 | $21K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 183 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.