| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BELL-ANDERSON AGENCY INC3 | 600 SW 39TH ST STE 200, RENTON, WA 98057 | REGENCE BLUESHIELD | $29K | — | $29K | 3.36% |
| BELL-ANDERSON AGENCY INC3 Filed as: BELL-ANDERSON AGENCY, INC | DBA GHB INSURANCE 556 LILLY RD STE A OLYMPIA, WA 98501 | PRINCIPAL LIFE INSURANCE COMPANY | $5K | $3K | $8K | 8.08% |
| ACRISURE LLC3 | PO BOX 2897 EVANS, GA 30809 | PRINCIPAL LIFE INSURANCE COMPANY | — | $986 | $986 | 0.99% |
| GHB INC3 Filed as: GHB INSURANCE | PO BOX 1608 OLYMPIA, WA 98507 | VISION SERVICE PLAN | $131 | — | $131 | 1.19% |
| GHB INC3 Filed as: GHB INSURANCE | PO BOX 1608 OLYMPIA, WA 98507 | TELADOC | $614 | — | $614 | 10.13% |
| GHB INC3 Filed as: GHB INSURANCE | PO BOX 1608 OLYMPIA, WA 98507 | FIRST CHOICE HEALTH PLAN | $325 | — | $325 | 11.97% |
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 | 106 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 106 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | REGENCE BLUESHIELD | 144 | $859K |
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 183 | $100K |
| Vision | VISION SERVICE PLAN | 118 | $11K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 183 | $100K |
| Other | FIRST CHOICE HEALTH PLAN | 140 | $3K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 183 | — |
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.