| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WELLS FARGO INSURANCE SERVICES3 | PO BOX 203588 DALLAS, TX 75320 | PREMERA BLUE CROSS | $49K | $8K | $57K | 2.86% |
| ARMFIELD HARRISON & THOMAS3 Filed as: ARMFIELD HARRISON & THOMAS INC | 600 UNIVERSITY ST SUITE 1300 SEATTLE, WA 98101 | PREMERA BLUE CROSS | $50K | $3K | $53K | 2.68% |
| WELLS FARGO INSURANCE SERVICES3 | 601 UNION STREET, SUITE 1300 SEATTLE, WA 98101 | DELTA DENTAL OF WASHINGTON | $6K | — | $6K | 2.53% |
| ARMFIELD HARRISON & THOMAS3 Filed as: ARMFIELD HARRISON & THOMAS INC | 600 UNIVERSITY ST SUITE 1300 SEATTLE, WA 98101 | DELTA DENTAL OF WASHINGTON | $5K | — | $5K | 2.05% |
| WELLS FARGO INSURANCE SERVICES3 | 601 UNION STREET, 34TH FLOOR SEATTLE, WA 98101 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $4K | — | $4K | 2.95% |
| ARMFIELD HARRISON & THOMAS3 Filed as: ARMFIELD HARRISON & THOMAS INC | 20 S KING ST LEESBURG, VA 20175 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $3K | — | $3K | 2.74% |
| AXA ASSISTANCE, USA5 | 122 SOUTH MICHIGAN AVENUE SUITE 1100 CHICAGO, IL 60603 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $49 | $49 | 0.04% |
| TOTAL BENEFIT SOLUTIONS3 | 155 108TH AVE NE SUITE 800 BELLEVUE, WA 98004 | VISION SERVICE PLAN | $3K | — | $3K | 10.00% |
| ARMFIELD HARRISON & THOMAS3 Filed as: ARMFIELD HARRISON & THOMAS INC | 600 UNIVERSITY ST SUITE 1300 SEATTLE, WA 98101 | VISION SERVICE PLAN | $1K | — | $1K | 5.24% |
| WELLS FARGO INSURANCE SERVICES3 | 999 3RD AVE SUITE 4100 SEATTLE, WA 98104 | VISION SERVICE PLAN | $1K | — | $1K | 4.76% |
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 | 128 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 132 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | PREMERA BLUE CROSS | 154 | $2.0M |
| Dental | DELTA DENTAL OF WASHINGTON | 418 | $231K |
| Vision | VISION SERVICE PLAN | 149 | $28K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 143 | $125K |
| Short-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 143 | $125K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 143 | $125K |
| Prescription drug | PREMERA BLUE CROSS | 154 | $2.0M |
| Other(2 contracts, 2 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 143 | $128K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 418 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.