| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| JAMEY MILLER INC3 Filed as: JAMEY MILLER, INC. | 2202 57TH STREET SE AUBURN, WA 98092 | CONTINENTAL AMERICAN INSURANCE COMPANY | $434 | $0 | $434 | 2.38% |
| MELANIE JENNINGS3 | 2101 263RD LANE SE SAMMAMISH, WA 98075 | CONTINENTAL AMERICAN INSURANCE COMPANY | $331 | $0 | $331 | 1.81% |
| HQ ADMINISTRATION, LLC3 | 14620 NE 181ST STREET WOODINVILLE, WA 98072 | CONTINENTAL AMERICAN INSURANCE COMPANY | $280 | $0 | $280 | 1.53% |
| KYONG H. GOINS3 | 2931 IST AVENUES, SUITE A SEATTLE, WA 98134 | CONTINENTAL AMERICAN INSURANCE COMPANY | $204 | $0 | $204 | 1.12% |
| MJ INSURANCE3 Filed as: NANCY L. WALDNER AND VARIOUS AGENTS | 227 BELLEVUE WAY NE BELLEVUE, WA 98004 | CONTINENTAL AMERICAN INSURANCE COMPANY | $189 | $0 | $189 | 1.03% |
| KIMBERLY J. MOGER3 | 24229 SE 147TH PLACE ISSAQUAH, WA 98027 | CONTINENTAL AMERICAN INSURANCE COMPANY | $157 | $0 | $157 | 0.86% |
| PAUL C. HAMILTON3 | 9630 CHERRY STREET EDMONDS, WA 98020 | CONTINENTAL AMERICAN INSURANCE COMPANY | $128 | $0 | $128 | 0.70% |
| SHANNON L TROWBRIDGE3 Filed as: SHANNON L. TROWBRIDGE | 202 SPRINGRISE LANE SUMMERVILLE, SC 29486 | TRANSAMERICA LIFE INSURANCE COMPANY | $102 | $0 | $102 | 1.41% |
| CHARLES H WEISSBERGER3 Filed as: CHARLES H. WEISSBERGER | 5128 CREEKMONTE DRIVE ROCHESTER, MI 48306 | TRANSAMERICA LIFE INSURANCE COMPANY | $84 | $0 | $84 | 1.16% |
| NANCY LAPHAM3 Filed as: NANCY L. WALDNER | 1685 134TH AVENUE SE APARTMENT 1206 BELLEVUE, WA 98005 | TRANSAMERICA LIFE INSURANCE COMPANY | $76 | $0 | $76 | 1.05% |
| C & K BENEFITS LLC3 Filed as: C & K BENEFITS, LLC | 106 RENAISSANCE CIRCLE MAULDIN, SC 29662 | TRANSAMERICA LIFE INSURANCE COMPANY | $70 | $0 | $70 | 0.96% |
| VOLUNTARY BENEFITS AT WORK3 Filed as: VOLUNTARY BENEFITSATWORK | 2121 NEWMARKET, SUITE 100 MARIETTA, GA 30067 | TRANSAMERICA LIFE INSURANCE COMPANY | $36 | $0 | $36 | 0.50% |
| MARK V. DENO3 | 1823 WEST NORTHRIDGE COURT SUITE 17 SPOKANE, WA 99208 | TRANSAMERICA LIFE INSURANCE COMPANY | $1 | $0 | $1 | 0.01% |
| NANCY LAPHAM3 Filed as: NANCY L. WALDNER | 3339 166TH PLACE SE BELLEVUE, WA 98008 | AFLAC | $92 | $0 | $92 | 2.56% |
| MARK VIRGIL DENO3 | 10305 MIDVALE AVENUE NORTH, SUITE A SEATTLE, WA 98008 | AFLAC | $58 | $0 | $58 | 1.62% |
| JAMEY MILLER INC3 Filed as: JAMEY J. MILLER | 12942 193RD AVENUE EAST BONNEY LAKE, MI 98391 | AFLAC | $46 | $0 | $46 | 1.28% |
| JAMEY MILLER INC3 Filed as: JAMEY MILLER, INC. | 12942 193RD AVENUE EAST BONNEY LAKE, WA 98391 | AFLAC | $38 | $0 | $38 | 1.06% |
| CHARLES H WEISSBERGER3 Filed as: CHARLES H. WEISSBERGER | 54110 MICHELE LANE SHELBY TOWNSHIP, MI 48315 | AFLAC | $36 | $0 | $36 | 1.00% |
| KIMBERLY FERGUSON3 Filed as: KIMBERLY MOGER | 25 SAGELAND EAST WENATCHEE, WA 98802 | AFLAC | $34 | $0 | $34 | 0.95% |
| MARY POHLMAN3 | 8400 24TH AVENUE SW SEATTLE, WA 98106 | AFLAC | $18 | $0 | $18 | 0.50% |
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 | 463 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 464 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental(2 contracts, 2 carriers) | DELTA DENTAL OF WASHINGTON | 578 | $231K |
| Vision | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO.. | 618 | $39K |
| Life insurance(3 contracts, 3 carriers) | CONTINENTAL AMERICAN INSURANCE COMPANY | 28 | $29K |
| Short-term disability(2 contracts, 2 carriers) | CONTINENTAL AMERICAN INSURANCE COMPANY | 28 | $26K |
| Other(2 contracts, 2 carriers) | CONTINENTAL AMERICAN INSURANCE COMPANY | 27 | $22K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 618 | — |
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.