| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BELL-ANDERSON AGENCY INC3 | PO BOX 1788 GRAND RAPIDS, MI 49501 | REGENCE BLUESHIELD | $23K | $4K | $27K | 3.77% |
| 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 | $7K | $3K | $10K | 9.79% |
| ACRISURE LLC3 | 2625 W PETERSON AVE CHICAGO, IL 60659 | PRINCIPAL LIFE INSURANCE COMPANY | — | $993 | $993 | 0.94% |
| BELL-ANDERSON AGENCY INC3 Filed as: BELL-ANDERSON AGENCY | 600 SW 39TH ST STE 200 RENTON, WA 98057 | VISION SERVICE PLAN | $758 | — | $758 | 7.91% |
| GHB INC3 Filed as: GHB INSURANCE | PO BOX 1608 OLYMPIA, WA 98507 | TELADOC | $526 | — | $526 | 9.48% |
| GHB INC3 Filed as: GHB INSURANCE | PO BOX 1608 OLYMPIA, WA 98507 | FIRST CHOICE HEALTH PLAN | $203 | — | $203 | 11.96% |
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 | 101 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 101 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | REGENCE BLUESHIELD | 134 | $733K |
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 151 | $106K |
| Vision | VISION SERVICE PLAN | 88 | $10K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 151 | $106K |
| Other(2 contracts, 2 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 151 | $108K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 151 | — |
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.