| 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 | 10.82% |
| NANCY LAPHAM3 Filed as: NANCY L. WALDNER | 1685 134TH AVENUE SE APARTMENT 1203 BELLEVUE, WA 98005 | TRANSAMERICA LIFE INSURANCE COMPANY | $909 | $0 | $909 | 4.23% |
| JAMEY MILLER INC3 Filed as: JAMEY MILLER, INC. | 2202 57TH STREET SE AUBURN, WA 98092 | TRANSAMERICA LIFE INSURANCE COMPANY | $841 | $0 | $841 | 3.91% |
| SHANNON L TROWBRIDGE3 Filed as: SHANNON L. TROWBRIDGE | 202 SPRINGRISE LANE SUMMERVILLE, SC 29486 | TRANSAMERICA LIFE INSURANCE COMPANY | $393 | $0 | $393 | 1.83% |
| C & K BENEFITS LLC3 Filed as: C AND K BENEFITS, LLC | 106 RENAISSANCE CIRCLE MAULDIN, SC 29662 | TRANSAMERICA LIFE INSURANCE COMPANY | $339 | $0 | $339 | 1.58% |
| VOLUNTARY BENEFITS AT WORK3 Filed as: VOLUNTARY BENEFITSAT WORK | 2121 NEWMARKET PARKWAY, SUITE 100 MARIETTA, GA 30067 | TRANSAMERICA LIFE INSURANCE COMPANY | $280 | $0 | $280 | 1.30% |
| CHARLES H WEISSBERGER3 Filed as: CHARLES H. WEISSBERGER | 5128 CREEKMONTE DRIVE ROCHESTER, MI 48306 | TRANSAMERICA LIFE INSURANCE COMPANY | $170 | $0 | $170 | 0.79% |
| MARK V. DENO | 1823 WEST NORTHRIDGE COURT SUITE 17 SPOKANE, WA 99208 | TRANSAMERICA LIFE INSURANCE COMPANY | $1 | $0 | $1 | 0.00% |
| JAMEY MILLER INC3 Filed as: JAMEY MILLER, INC. | 2202 57TH STREET SE AUBURN, WA 98092 | CONTINENTAL AMERICAN INSURANCE COMPANY | $2K | $0 | $2K | 17.47% |
| NANCY LAPHAM3 Filed as: NANCY L. WALDNER | 227 BELLEVUE WAY NE, SUITE 305 BELLEVUE, WA 98004 | CONTINENTAL AMERICAN INSURANCE COMPANY | $322 | $0 | $322 | 2.89% |
| KYONG H. GOINS3 | 2931 1ST AVENUES, SUITE A SEATLLE, WA 98134 | CONTINENTAL AMERICAN INSURANCE COMPANY | $126 | $0 | $126 | 1.13% |
| CHARLES H WEISSBERGER3 Filed as: CHARLES H. WEISSBERGER | 3100 WEST ROAD, SUITE 300 EAST LANSING, MI 48823 | CONTINENTAL AMERICAN INSURANCE COMPANY | $58 | $0 | $58 | 0.52% |
| LAUREN E. WALDNER3 | 10325 SE 16TH STREET BELLEVUE, WA 98004 | CONTINENTAL AMERICAN INSURANCE COMPANY | $51 | $0 | $51 | 0.46% |
| KIMBERLY J. MOGER3 | 24229 SE 147TH PLACE ISSAQUAH, WA 98027 | CONTINENTAL AMERICAN INSURANCE COMPANY | $36 | $0 | $36 | 0.32% |
| MJ INSURANCE3 Filed as: REBECCA COTTER AND VARIOUS AGENTS | 13526 160TH AVENUE NE REDMOND, WA 98052 | CONTINENTAL AMERICAN INSURANCE COMPANY | $30 | $0 | $30 | 0.27% |
| JAMEY MILLER INC3 Filed as: JAMEY J. MILLER | 6270 TERRACE VIEW LANE SE AUBURN, WA 98092 | AFLAC | $840 | $0 | $840 | 14.85% |
| NANCY LAPHAM3 Filed as: NANCY L. WALDNER | 3339 166TH PLACE SE BELLEVUE, WA 98008 | AFLAC | $181 | $0 | $181 | 3.20% |
| CHARLES H WEISSBERGER3 Filed as: CHARLES H. WEISSBERGER | 54110 MICHELLE LANE SHELBY TOWNSHIP, MI 48315 | AFLAC | $54 | $0 | $54 | 0.95% |
| MARK VIRGIL DENO3 | 1823 WEST NORTHRIDGE COURT APARTMENT 17 SPOKANE, WA 99208 | AFLAC | $36 | $0 | $36 | 0.64% |
| KIMBERLY FERGUSON3 Filed as: KIMBERLY MOGER | 25 SAGELAND EAST WENATCHEE, WA 98802 | AFLAC | $34 | $0 | $34 | 0.60% |
| MARY POHLMAN3 | 27735 214TH AVENUE SE MAPLE VALLEY, WA 98038 | AFLAC | $18 | $0 | $18 | 0.32% |
| MJ INSURANCE3 Filed as: EDWARD BRENNAN AND VARIOUS AGENTS | 5577 LAKEMONT BOULEVARD SE APARTMENT 1507 BELLEVUE, WA 98006 | AFLAC | $13 | $0 | $13 | 0.23% |
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 | 471 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 475 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental(2 contracts, 2 carriers) | DELTA DENTAL OF WASHINGTON | 471 | $169K |
| Vision | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO.. | 552 | $37K |
| Life insurance(3 contracts, 3 carriers) | TRANSAMERICA LIFE INSURANCE COMPANY | 125 | $38K |
| Short-term disability(2 contracts, 2 carriers) | TRANSAMERICA LIFE INSURANCE COMPANY | 125 | $33K |
| Other(2 contracts, 2 carriers) | CONTINENTAL AMERICAN INSURANCE COMPANY | 22 | $17K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 552 | — |
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.