| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| FORTUNE MANAGEMENT, INC.3 | PO BOX 75009 SEATTLE, WA 98125 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO.. | $4K | $0 | $4K | 8.38% |
| ASSUREDPARTNERS3 Filed as: ASSUREDPARTNERS OF NEVADA, LLC | 5985 HOME GARDENS DRIVE, SUITE A RENO, NV 89502 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO.. | $257 | $0 | $257 | 0.60% |
| NANCY LAPHAM3 Filed as: NANCY L. WALDNER | 1685 134TH AVENUE SE APARTMENT 1203 BELLEVUE, WA 98005 | TRANSAMERICA INSURANCE COMPANY | $3K | $0 | $3K | 11.90% |
| CHARLES H WEISSBERGER3 Filed as: CHARLES H. WEISSBERGER | 308 GRAHAM AVENUE SE RENTON, WA 98059 | TRANSAMERICA INSURANCE COMPANY | $1K | $0 | $1K | 3.84% |
| SHANNON L TROWBRIDGE3 Filed as: SHANNON L. TROWBRIDGE | 202 SPRINGRISE LANE SUMMERVILLE, SC 29486 | TRANSAMERICA INSURANCE COMPANY | $881 | $0 | $881 | 3.03% |
| C & K BENEFITS LLC3 Filed as: C AND K BENEFITS LLC | 106 RENAISSANCE CIRCLE MAULDIN, SC 29662 | TRANSAMERICA INSURANCE COMPANY | $786 | $0 | $786 | 2.70% |
| VOLUNTARY BENEFITS AT WORK3 Filed as: VOLUNTARY BENEFITSAT WORK | 2121 NEWMARKET PARKWAY SE SUITE 100 MARIETTA, GA 30067 | TRANSAMERICA INSURANCE COMPANY | $764 | $0 | $764 | 2.63% |
| NANCY LAPHAM3 Filed as: NANCY L. WALDNER | 227 BELLEVUE WAY NE, SUITE 305 BELLEVUE, WA 98004 | CONTINENTAL AMERICAN INSURANCE COMPANY | $2K | $0 | $2K | 22.60% |
| LAUREN E. WALDNER3 | 10325 SE 16TH STREET BELLEVUE, WA 98004 | CONTINENTAL AMERICAN INSURANCE COMPANY | $800 | $0 | $800 | 7.95% |
| CHARLES H WEISSBERGER3 Filed as: CHARLES H. WEISSBERGER | 3100 WEST ROAD, SUITE 300 EAST LANSING, MI 48823 | CONTINENTAL AMERICAN INSURANCE COMPANY | $288 | $0 | $288 | 2.86% |
| KIMBERLY J. MOGER3 | 24229 SE 147TH PLACE ISSAQUAH, WA 98027 | CONTINENTAL AMERICAN INSURANCE COMPANY | $242 | $0 | $242 | 2.41% |
| MJ INSURANCE3 Filed as: MARY POHLMAN AND VARIOUS AGENTS | 6102 90TH AVENUE SE MERCER ISLAND, WA 98040 | CONTINENTAL AMERICAN INSURANCE COMPANY | $112 | $0 | $112 | 1.11% |
| REBECCA J. COTTER3 | 13526 160TH AVENUE NE REDMOND, WA 98052 | CONTINENTAL AMERICAN INSURANCE COMPANY | $110 | $0 | $110 | 1.09% |
| MARK V. DENO3 | 1823 WEST NORTHRIDGE COURT APARTMENT 17 SPOKANE, WA 99208 | CONTINENTAL AMERICAN INSURANCE COMPANY | $82 | $0 | $82 | 0.81% |
| NANCY LAPHAM3 Filed as: NANCY L. WALDNER | 227 BELLEVUE WAY NE, SUITE 305 BELLEVUE, WA 98004 | AFLAC | $795 | $77 | $872 | 16.28% |
| MARK VIRGIL DENO3 | 1823 WEST NORTHRIDGE COURT APARTMENT 17 SPOKANE, WA 99208 | AFLAC | $188 | $48 | $236 | 4.41% |
| KIMBERLY FERGUSON3 Filed as: KIMBERLY MOGER | 24229 SE 147TH PLACE ISSAQUAH, WA 98027 | AFLAC | $172 | $22 | $194 | 3.62% |
| CHARLES H WEISSBERGER3 Filed as: CHARLES H. WEISSBERGER | 5128 CREEKMONTE DRIVE ROCHESTER, MI 48306 | AFLAC | $135 | $25 | $160 | 2.99% |
| LAUREN E. WALDNER3 | 3339 166TH PLACE SE BELLEVUE, WA 98008 | AFLAC | $76 | $0 | $76 | 1.42% |
| CHARLES H WEISSBERGER3 Filed as: CHARLES H. WEISSBERGER AND OTHER AG | 3100 WEST ROAD, SUITE 300 EAST LANSING, MI 48823 | AFLAC | $45 | $0 | $45 | 0.84% |
| MARY POHLMAN3 | 27735 214TH AVENUE SE MAPLE VALLEY, WA 98038 | AFLAC | $34 | $4 | $38 | 0.71% |
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 | 476 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 9 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 485 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental(2 contracts, 2 carriers) | DELTA DENTAL OF WASHINGTON | 665 | $228K |
| Vision | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO.. | 673 | $43K |
| Life insurance(3 contracts, 3 carriers) | TRANSAMERICA INSURANCE COMPANY | 121 | $44K |
| Short-term disability(2 contracts, 2 carriers) | TRANSAMERICA INSURANCE COMPANY | 121 | $39K |
| Other(2 contracts, 2 carriers) | CONTINENTAL AMERICAN INSURANCE COMPANY | 121 | $15K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 673 | — |
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.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.