| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NORTHWEST | 601 UNION STREET, SUITE 1000 SEATTLE, WA 98101 | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON OPTIONS, INC. | $5K | $0 | $5K | 2.42% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 777 108TH AVENUE NE, SUITE 200 BELLEVUE, WA 98004 | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON OPTIONS, INC. | $3K | $0 | $3K | 1.18% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NORTHWEST | 601 UNION STREET, SUITE 1000 SEATTLE, WA 98101 | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON | $3K | $0 | $3K | 1.77% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 777 108TH AVENUE NE, SUITE 200 BELLEVUE, WA 98004 | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON | $3K | $0 | $3K | 1.76% |
| USI INSURANCE SERVICES LLC3 | 200 SUMMIT LAKE DRIVE, SUITE 350 VALHALLA, NY 10595 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $2K | $728 | $2K | 4.58% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD, 5TH FLOOR ROLLING MEADOWS, IL 60008 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $2K | $451 | $2K | 4.51% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF WASHINGTON, INC. | 2106 PACIFIC AVENUE, SUITE 501 TACOMA, WA 98402 | AFLAC | $286 | $0 | $286 | 3.00% |
| NORTHWEST BENEFIT ADVISORS, INC.3 | 8151 164TH AVENUE NE, SUITE 411 REDMOND, WA 98052 | AFLAC | $269 | $0 | $269 | 2.82% |
| DAVID ROJAS3 | 169 EAGLE RIDGE DRIVE EAST PUYALLUP, WA 98374 | AFLAC | $147 | $0 | $147 | 1.54% |
| MARY L. JOCHUM3 | 17901 123RD COURT SE RENTON, WA 98058 | AFLAC | $130 | $0 | $130 | 1.36% |
| BROOKE BACHESTA3 | 8151 164TH AVENUE NE SUITE 711 REDMOND, WA 98052 | AFLAC | $88 | $0 | $88 | 0.92% |
| BARBARA M DICKSON3 Filed as: BARBARA M. DICKSON AND OTHER AGENTS | 8040 161ST AVENUE NE, SUITE 411 REDMOND, WA 98052 | AFLAC | $43 | $0 | $43 | 0.45% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NORTHWEST | 601 UNION STREET, SUITE 1000 SEATTLE, WA 98101 | AFLAC | $4 | $0 | $4 | 0.04% |
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 | 91 | 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) | 91 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON OPTIONS, INC. | 51 | $416K |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 91 | $51K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 91 | $51K |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 91 | $51K |
| Short-term disability | AFLAC | 14 | $10K |
| Prescription drug(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON OPTIONS, INC. | 51 | $416K |
| Other(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 91 | $60K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 91 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.