| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | 777 108TH AVENUE NE, SUITE 200 BELLEVUE, WA 98004 | PREMERA BLUE CROSS | $119K | $15K | $134K | 3.36% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 777 108TH AVENUE NE, SUITE 200 BELLEVUE, WA 98004 | DELTA DENTAL OF WASHINGTON | $24K | $0 | $24K | 4.60% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 777 108TH AVENUE NE, SUITE 200 BELLEVUE, WA 98004 | METROPOLITAN LIFE INSURANCE COMPANY | $16K | $216 | $16K | 9.37% |
| CONNEXION INSURANCE SOLUTIONS3 Filed as: CONNEXION PREMERA | PO BOX 34315 SEATTLE, WA 98124 | METROPOLITAN LIFE INSURANCE COMPANY | $3K | $56 | $3K | 1.47% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $2K | $2K | 0.89% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 777 108TH AVENUE NE, SUITE 200 BELLEVUE, WA 98004 | VISION SERVICE PLAN | $2K | $0 | $2K | 3.11% |
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 | 475 | 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) | 475 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | PREMERA BLUE CROSS | 864 | $4.0M |
| Dental | DELTA DENTAL OF WASHINGTON | 852 | $532K |
| Vision | VISION SERVICE PLAN | 463 | $61K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 621 | $174K |
| Short-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 621 | $174K |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 621 | $174K |
| Prescription drug | PREMERA BLUE CROSS | 864 | $4.0M |
| Other(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 621 | $185K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 864 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.