| 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 | 9.95% |
| NANCY LAPHAM3 Filed as: NANCY L. WALDNER | 1685 134TH AVENUE SE APARTMENT 1203 BELLEVUE, WA 98005 | TRANSAMERICA INSURANCE COMPANY | $1K | $0 | $1K | 5.03% |
| JAMEY MILLER INC3 Filed as: JAMEY MILLER, INC. | 2202 57TH STREET SE AURBURN, WA 98092 | TRANSAMERICA INSURANCE COMPANY | $434 | $0 | $434 | 1.81% |
| SHANNON L TROWBRIDGE3 Filed as: SHANNON L. TROWBRIDGE | 202 SPRINGRISE LANE SUMMERVILLE, SC 29486 | TRANSAMERICA INSURANCE COMPANY | $415 | $0 | $415 | 1.73% |
| C & K BENEFITS LLC3 Filed as: C AND K BENEFITS, LLC | 106 RENAISSANCE CIRLCE MAULDIN, SC 29662 | TRANSAMERICA INSURANCE COMPANY | $368 | $0 | $368 | 1.54% |
| VOLUNTARY BENEFITS AT WORK3 Filed as: VOLUNTARY BENEFITSAT WORK | 2121 NEW MARKET PARKWAY SE SUITE 100 MARIETTA, GA 30067 | TRANSAMERICA INSURANCE COMPANY | $283 | $0 | $283 | 1.18% |
| CHARLES H WEISSBERGER3 Filed as: CHARLES H. WEISSBERGER | 5128 CREEKMONTE DRIVE ROCHESTER, MI 48306 | TRANSAMERICA INSURANCE COMPANY | $247 | $0 | $247 | 1.03% |
| MJ INSURANCE3 Filed as: MARK V. DENO AND VARIOUS AGENTS | 1823 WEST NORTHRIDGE COURT SUITE 17 SPOKANE, WA 99208 | TRANSAMERICA INSURANCE COMPANY | $64 | $0 | $64 | 0.27% |
| NANCY LAPHAM3 Filed as: NANCY L. WALDNER | 277 BELLEVUE WAY NE, SUITE 305 BELLEVUE, WA 98004 | CONTINENTAL AMERICAN INSURANCE COMPANY | $1K | $0 | $1K | 8.41% |
| JAMEY MILLER INC3 Filed as: JAMEY MILLER, INC. | 10375 CENTURION PARKWAY NORTH SUITE 300 JACKSONVILLE, FL 32256 | CONTINENTAL AMERICAN INSURANCE COMPANY | $481 | $0 | $481 | 4.04% |
| LAUREN E. WALDNER3 | 10325 SE 16TH STREET BELLEVUE, WA 98004 | CONTINENTAL AMERICAN INSURANCE COMPANY | $188 | $0 | $188 | 1.58% |
| CHARLES H WEISSBERGER3 Filed as: CHARLES H. WEISSBERGER | 310 WEST ROAD, SUITE 300 EAST LANSING, MI 48823 | CONTINENTAL AMERICAN INSURANCE COMPANY | $130 | $0 | $130 | 1.09% |
| KIMBERLEY J. MOGER | 24229 SE 147TH PLACE ISSAQUAH, WA 98027 | CONTINENTAL AMERICAN INSURANCE COMPANY | $101 | $0 | $101 | 0.85% |
| MJ INSURANCE3 Filed as: KYONG H. GOINS AND VARIOUS AGENTS | 2931 1ST AVENUES, SUITE A SEATTLE, WA 98134 | CONTINENTAL AMERICAN INSURANCE COMPANY | $82 | $0 | $82 | 0.69% |
| REBECCA J. COTTER3 | 13526 160TH AVENUE NE REDMOND, WA 98052 | CONTINENTAL AMERICAN INSURANCE COMPANY | $36 | $0 | $36 | 0.30% |
| JAMEY MILLER INC3 Filed as: JAMEY J. MILLER | 2202 57TH STREET SE AUBURN, WA 98092 | AFLAC | $461 | $0 | $461 | 8.08% |
| NANCY LAPHAM3 Filed as: NANCY L. WALDNER | 3339 166TH PLACE SE BELLEVUE, WA 98008 | AFLAC | $367 | $68 | $435 | 7.62% |
| CHARLES H WEISSBERGER3 Filed as: CHARLES H. WEISSBERGER | 5128 CREEKMONTE DRIVE ROCHESTER, MI 48306 | AFLAC | $86 | $14 | $100 | 1.75% |
| MJ INSURANCE3 Filed as: LAUREN WALDNER AND VARIOUS AGENTS | 3339 166TH PLACE SE BELLEVUE, WA 98008 | AFLAC | $86 | $13 | $99 | 1.73% |
| JAMEY MILLER INC3 Filed as: JAMEY MILLER, INC. | 2202 57TH STREET SE AUBURN, WA 98092 | AFLAC | $50 | $0 | $50 | 0.88% |
| MJ INSURANCE3 Filed as: EDWARD F. BRENNAN | 5577 LAKEMOUNT BOULEVARD SE APARTMENT 1507 BELLEVUE, WA 98006 | AFLAC | $40 | $0 | $40 | 0.70% |
| KIMBERLEY MOGER3 | 4543 160TH AVENUE SE BELLEVUE, WA 98006 | AFLAC | $37 | $0 | $37 | 0.65% |
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 | 477 | 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) | 486 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental(2 contracts, 2 carriers) | DELTA DENTAL OF WASHINGTON | 632 | $208K |
| Vision | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO.. | 616 | $41K |
| Life insurance(3 contracts, 3 carriers) | TRANSAMERICA INSURANCE COMPANY | 130 | $42K |
| Short-term disability(2 contracts, 2 carriers) | TRANSAMERICA INSURANCE COMPANY | 130 | $36K |
| Other(2 contracts, 2 carriers) | CONTINENTAL AMERICAN INSURANCE COMPANY | 130 | $18K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 632 | — |
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."
No prospect flags tripped on this filing.