| 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 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $3K | $33K | $36K | 3.39% |
| BCI GROUP, INC.3 Filed as: BCI GROUP | 6979 SOUTHEAST LAKE ROAD PORTLAND, OR 97267 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $10K | $3K | $13K | 19.02% |
| ANDREW N LUCCOCK3 Filed as: ANDREW N. LUCCOCK | 23984 SOUTHWEST SHADY GROVE DRIVE SHERWOOD, OR 97140 | AFLAC | $3K | $91 | $3K | 6.86% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHWEST LLC | 6979 SOUTHEAST LAKE ROAD PORTLAND, OR 97267 | AFLAC | $1K | $0 | $1K | 3.73% |
| BRYAN G CORBIN LLC3 Filed as: BRYAN G. CORBIN LLC | 6950 SOUTHWEST HAMPTON STREET SUITE 260 TIGARD, OR 97223 | AFLAC | $400 | $21 | $421 | 1.06% |
| BCI GROUP, INC.3 Filed as: BCI GROUP | 6979 SOUTHEAST LAKE ROAD PORTLAND, OR 97267 | STARMOUNT LIFE INSURANCE COMPANY | $862 | $387 | $1K | 14.48% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHWEST LLC | UNKNOWN SHERWOOD, OR 97140 | WILLAMETTE DENTAL INSURANCE, INC. | $266 | $0 | $266 | 5.00% |
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 | 137 | 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) | 137 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 153 | $1.1M |
| Dental(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 153 | $1.1M |
| Vision | STARMOUNT LIFE INSURANCE COMPANY | 66 | $9K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 137 | $68K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 137 | $68K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 137 | $68K |
| Prescription drug | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 153 | $1.1M |
| Other(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 137 | $107K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 153 | — |
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.