| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHWEST LLC | P.O. BOX 2158 RIVERSIDE, CA 92516 | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | $5K | $3K | $8K | 0.26% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHWEST LLC | P.O. BOX 3018 BOTHELL, WA 98041 | UNITEDHEALTHCARE INSURANCE COMPANY | — | $170 | $170 | 0.01% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHWEST LLC | P.O. BOX 3018 BOTHELL, WA 98041 | UNITEDHEALTHCARE INSURANCE COMPANY | -$1 | -$43 | -$44 | -0.00% |
| VARIOUS - SEE ATTACHED3 | P.O. BOX 1365 COLUMBIA, SC 29202 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $79K | $27K | $106K | 38.55% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHWEST LLC | P.O. BOX 2158 RIVERSIDE, CA 92506 | UNITEDHEALTHCARE INSURANCE COMPANY | $8K | — | $8K | 5.08% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | UNITEDHEALTHCARE INSURANCE COMPANY | $8K | — | $8K | 15.41% |
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 | 442 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 5 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 447 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | 1,128 | $6.1M |
| Dental | UNITEDHEALTHCARE INSURANCE COMPANY | 1,128 | $2.2M |
| Vision(3 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | 1,128 | $6.1M |
| Life insurance(3 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 715 | $481K |
| Short-term disability(3 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 715 | $481K |
| Long-term disability(3 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 715 | $481K |
| Prescription drug(3 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | 1,128 | $6.1M |
| Other(4 contracts, 3 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 715 | $491K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,128 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.