| 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 THE NORTHWEST | $27K | $720 | $27K | 1.51% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NW LLC | PO BOX 3018 BOTHELL, WA 98041 | STANDARD INSURANCE COMPANY | $10K | $4K | $13K | 7.95% |
| BCI GROUP, INC.3 | UNKNOWN PORTLAND, OR 97230 | WILLAMETTE DENTAL INSURANCE, INC. | $2K | $0 | $2K | 3.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHWEST LLC | 307 OAK STREET HOOD RIVER, OR 97031 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $154 | $0 | $154 | 7.02% |
| MARGARET BRYANT3 | 18014 SOUTHWEST BELMORE AVENUE LAKE OSWEGO, OR 97035 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $38 | $0 | $38 | 1.73% |
| KAREN CLAY KUNKLER3 | 415 SOUTHEAST 177TH AVENUE SUITE 236 VANCOUVER, WA 98683 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $27 | $0 | $27 | 1.23% |
| HEARTSEASE LLC3 | 1521 NORTHEAST 63RD AVENUE HILLSBORO, OR 97124 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $26 | $0 | $26 | 1.19% |
| WORKSITE BENEFITS GROUP INC3 | 112 NORTHWEST 114TH STREET VANCOUVER, WA 98685 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $19 | $0 | $19 | 0.87% |
| MJ INSURANCE3 Filed as: PATRICK WAGNER & VARIOUS AGENTS | 2232 HIGH COUNTRY DRIVE CARROLLTON, TX 75007 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $12 | $0 | $12 | 0.55% |
| TIMOTHY J REED3 Filed as: TIMOTHY J. REED | 21 AZALEA DRIVE LUMBERTON, NJ 08048 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $9 | $0 | $9 | 0.41% |
| HIPSTER ONCE LLC4 | 1665 NORTHWEST HIGHLAND DRIVE CORVALLIS, OR 97330 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $58 | $0 | $58 | 6.32% |
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 | 700 | 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) | 700 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | 236 | $1.8M |
| Dental(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | 236 | $1.9M |
| Vision | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | 236 | $1.8M |
| Life insurance | STANDARD INSURANCE COMPANY | 215 | $169K |
| Short-term disability(2 contracts, 2 carriers) | STANDARD INSURANCE COMPANY | 215 | $171K |
| Long-term disability | STANDARD INSURANCE COMPANY | 215 | $169K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | 236 | $1.8M |
| Other(4 contracts, 4 carriers) | STANDARD INSURANCE COMPANY | 700 | $187K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 700 | — |
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.