| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHWEST, LLC | PO BOX 2158 RIVERSIDE, CA 92516 | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | $39K | $2K | $40K | 1.98% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHWEST, LLC | UNKNOWN PORTLAND, OR 97230 | WILLAMETTE DENTAL INSURANCE, INC. | $3K | $0 | $3K | 3.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHWEST, LLC | PO BOX 749083 LOS ANGELES, CA 90074 | STANDARD INSURANCE COMPANY | $3K | $0 | $3K | 7.77% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHEAST LIMITED | 1065 AVENUE OF THE AMERICAS NEW YORK, NY 10018 | STANDARD INSURANCE COMPANY | $811 | $0 | $811 | 1.89% |
| BCI GROUP, INC.3 Filed as: BCI GROUP, INC | PO BOX 749083 LOS ANGELES, CA 90074 | STANDARD INSURANCE COMPANY | -$953 | $0 | -$953 | -2.22% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHWEST, LLC | 307 OAK STREET HOOD RIVER, OR 97031 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $566 | $0 | $566 | 7.84% |
| MARGARET BRYANT3 | 18014 SW BELMORE AVENUE LAKE OSWEGO, OR 97035 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $140 | $23 | $163 | 2.26% |
| KAREN CLAY KUNKLER3 | 1709 NW 45TH AVENUE CAMAS, WA 98607 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $132 | $9 | $141 | 1.95% |
| HEARTSEASE LLC3 Filed as: HEARTSEASE, LLC | 1521 NE 63RD AVENUE HILLSBORO, OR 97124 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $90 | $26 | $116 | 1.61% |
| PREMIER WORKSITE SOLUTIONS INC3 Filed as: PREMIER WORKSITE SOLUTIONS, INC. | 112 NW 114TH STREET VANCOUVER, WA 98685 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $75 | $19 | $94 | 1.30% |
| PATRICK IAN WAGNER3 | 4580 PEBBLE BROOK LANE PLANO, TX 75093 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $51 | $0 | $51 | 0.71% |
| MJ INSURANCE3 Filed as: TIMOTHY J REED AND VARIOUS AGENTS | 21 AZALEA DRIVE LUMBERTON, NJ 08048 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $50 | $0 | $50 | 0.69% |
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 | 255 | 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) | 255 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | 255 | $2.0M |
| Dental(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | 384 | $2.1M |
| Vision | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | 255 | $2.0M |
| Life insurance | STANDARD INSURANCE COMPANY | 208 | $43K |
| Short-term disability(2 contracts, 2 carriers) | STANDARD INSURANCE COMPANY | 208 | $50K |
| Long-term disability | STANDARD INSURANCE COMPANY | 208 | $43K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | 255 | $2.0M |
| Other(2 contracts, 2 carriers) | STANDARD INSURANCE COMPANY | 208 | $50K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 384 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.