| 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 | $33K | $9 | $33K | 1.78% |
| BCI GROUP, INC.3 | UNKNOWN PORTLAND, OR 97230 | WILLAMETTE DENTAL INSURANCE, INC. | $3K | $0 | $3K | 2.99% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHWEST LLC | PO BOX 749083 LOS ANGELES, CA 90074 | STANDARD INSURANCE COMPANY | $3K | $0 | $3K | 4.95% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NE LIMITED | 1065 AVENUE OF THE AMERICAS NEW YORK, NY 10018 | STANDARD INSURANCE COMPANY | — | $583 | $583 | 0.99% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHWEST LLC | PO BOX 749083 LOS ANGELES, CA 90074 | STANDARD INSURANCE COMPANY | $2K | $0 | $2K | 5.57% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NE LIMITED | 1065 AVENUE OF THE AMERICAS NEW YORK, NY 10018 | STANDARD INSURANCE COMPANY | — | $418 | $418 | 0.99% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHWEST LLC | PO BOX 749083 LOS ANGELES, CA 90074 | STANDARD INSURANCE COMPANY | $985 | $0 | $985 | 11.12% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NE LIMITED | 1065 AVENUE OF THE AMERICAS NEW YORK, NY 10018 | STANDARD INSURANCE COMPANY | — | $87 | $87 | 0.98% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHWEST LLC | 307 OAK STREET HOOD RIVER, OR 97031 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $441 | $0 | $441 | 7.41% |
| MARGARET BRYANT3 | 18014 SW BELMORE AVENUE LAKE OSWEGO, OR 97035 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $116 | $9 | $125 | 2.10% |
| KAREN CLAY KUNKLER3 | 1709 NW 45TH AVENUE CAMAS, WA 98607 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $109 | $7 | $116 | 1.95% |
| HEARTSEASE LLC3 | 1521 NE 63RD AVENUE HILLSBORO, OR 97124 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $77 | $12 | $89 | 1.49% |
| PREMIER WORKSITE SOLUTIONS INC3 Filed as: PREMIER WORKSITE SOLUTIONS INC. | 112 NW 114TH STREET VANCOUVER, WA 98685 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $60 | $14 | $74 | 1.24% |
| MJ INSURANCE3 Filed as: TIMOTHY J. REED AND VARIOUS AGENTS | 21 AZALEA DRIVE LUMBERTON, NJ 08048 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $42 | $0 | $42 | 0.71% |
| PATRICK IAN WAGNER3 | 2232 HIGH COUNTRY DRIVE CARROLLTON, TX 75007 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $38 | $0 | $38 | 0.64% |
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 | 199 | 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) | 199 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | 217 | $1.9M |
| Dental(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | 217 | $2.0M |
| Vision | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | 217 | $1.9M |
| Life insurance | STANDARD INSURANCE COMPANY | 199 | $42K |
| Short-term disability(2 contracts, 2 carriers) | STANDARD INSURANCE COMPANY | 199 | $65K |
| Long-term disability | STANDARD INSURANCE COMPANY | 40 | $9K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | 217 | $1.9M |
| Other(2 contracts, 2 carriers) | STANDARD INSURANCE COMPANY | 199 | $48K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 217 | — |
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.