| 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 | PREMERA BLUE CROSS | $103K | $13K | $116K | 4.49% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHWEST LLC | 12100 NORTHEAST 195TH STREET SUITE 200 BOTHELL, WA 98011 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $22K | $0 | $22K | 3.69% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHWEST LLC | PO BOX 2158 RIVERSIDE, CA 92516 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $9K | $9K | 1.48% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHWEST LLC | PO BOX 3018 BOTHELL, WA 98041 | VISION SERVICE PLAN | $2K | $0 | $2K | 4.33% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHWEST LLC | 375 SOUTH GRAND AVENUE PULLMAN, WA 99163 | HARTFORD LIFE AND ACCIDENT | $185 | $0 | $185 | 15.00% |
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 | 165 | 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) | 165 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | PREMERA BLUE CROSS | 314 | $2.6M |
| Vision | VISION SERVICE PLAN | 176 | $35K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 171 | $609K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 171 | $609K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 171 | $609K |
| Prescription drug | PREMERA BLUE CROSS | 314 | $2.6M |
| Other(3 contracts, 3 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 175 | $615K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 314 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.