| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHWEST LLC | 2 CENTERPOINTE DRIVE, SUITE 650 LAKE OSWEGO, OR 97035 | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | $33K | $1K | $34K | 1.82% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHWEST LLC | PO BOX 3018 BOTHELL, WA 98041 | STANDARD INSURANCE COMPANY | $10K | $6K | $15K | 8.80% |
| WATCHTOWER TECHNOLOGIES INC3 | 227 WEST MONROE STREET, SUITE 5200 CHICAGO, IL 60606 | STANDARD INSURANCE COMPANY | $0 | $2K | $2K | 1.05% |
| 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 3018 BOTHELL, WA 98041 | STANDARD INSURANCE COMPANY | $1K | $0 | $1K | 9.19% |
| WATCHTOWER TECHNOLOGIES INC3 | 227 WEST MONROE STREET, SUITE 5200 CHICAGO, IL 60606 | STANDARD INSURANCE COMPANY | $0 | $236 | $236 | 1.50% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHWEST LLC | 307 OAK STREET HOOD RIVER, OR 97031 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $121 | $0 | $121 | 6.42% |
| MAGARET BRYANT3 | 18014 BELMORE AVENUE LAKE OSWEGO, OR 97035 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $29 | $0 | $29 | 1.54% |
| KAREN CLAY KUNKLER3 | 415 SE 177TH AVENUE, UNIT 236 VANCOUVER, WA 98683 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $21 | $0 | $21 | 1.11% |
| HEARTSEASE LLC3 | 1521 NE 63RD AVENUE HILLSBORO, OR 97124 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $19 | $0 | $19 | 1.01% |
| WORKSITE BENEFITS GROUP INC3 | 112 NW 114TH STREET VANCOUVER, WA 98685 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $15 | $0 | $15 | 0.80% |
| HOWARD HOROWITZ3 Filed as: HOWARD J. HOROWITZ | 2610 ALCOTT STREET CARMEL, IN 46032 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $6 | $0 | $6 | 0.32% |
| TIMOTHY J REED3 Filed as: TIMOTHY J. REED | 21 AZALEA DRIVE LUMBERTON, NJ 08048 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $6 | $0 | $6 | 0.32% |
| HIPSTER ONCE LLC4 | 1665 NW HIGHLAND DRIVE CORVALLIS, OR 97330 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $50 | $0 | $50 | 7.92% |
| CURTIS A. ALMQUIST4 | 1665 NW HIGHLAND DRIVE CORVALIS, OR 97330 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $21 | $0 | $21 | 3.33% |
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 | 191 | 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) | 191 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | 229 | $1.9M |
| Dental(2 contracts, 2 carriers) | STANDARD INSURANCE COMPANY | 191 | $270K |
| Vision(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | 229 | $2.0M |
| Life insurance | STANDARD INSURANCE COMPANY | 191 | $173K |
| Short-term disability(2 contracts, 2 carriers) | STANDARD INSURANCE COMPANY | 2 | $18K |
| Long-term disability | STANDARD INSURANCE COMPANY | 191 | $173K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | 229 | $1.9M |
| Other(4 contracts, 4 carriers) | STANDARD INSURANCE COMPANY | 700 | $189K |
| 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.