| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CRYSTAL IBC LLC3 Filed as: CRYSTAL IBC LLC - NY | 32 OLD SLIP FL 17 NEW YORK, NY 10005 | UNITEDHEALTHCARE INSURANCE COMPANY | $51K | — | $51K | 4.00% |
| ALLIANT INSURANCE SERVICES, INC.3 | 1420 5TH AVE STE 1500 SEATTLE, WA 98101 | DELTA DENTAL OF WASHINGTON | $6K | — | $6K | 9.10% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES | 701 B ST FL 6 SAN DIEGO, CA 92101 | VISION SERVICE PLAN | $598 | — | $598 | 5.87% |
| ALLIANT INSURANCE SERVICES, INC.3 | 1420 5TH AVE STE 1500 SEATTLE, WA 98101 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | $239 | $2K | 17.77% |
| ALLIANT INSURANCE SERVICES, INC.3 | 1420 5TH AVE STE 1500 SEATTLE, WA 98101 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $981 | $195 | $1K | 17.98% |
| ALLIANT INSURANCE SERVICES, INC.3 | 1420 5TH AVE STE 1500 SEATTLE, WA 98101 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $694 | $138 | $832 | 17.99% |
| ALLIANT INSURANCE SERVICES, INC.3 | 1420 5TH AVE STE 1500 SEATTLE, WA 98101 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $123 | $40 | $163 | 19.81% |
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 | 104 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 2 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 108 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITEDHEALTHCARE INSURANCE COMPANY | 199 | $1.3M |
| Dental | DELTA DENTAL OF WASHINGTON | 154 | $68K |
| Vision | VISION SERVICE PLAN | 118 | $10K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 279 | $9K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 34 | $7K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 34 | $5K |
| Prescription drug | UNITEDHEALTHCARE INSURANCE COMPANY | 199 | $1.3M |
| Other(2 contracts) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 279 | $9K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 279 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.