| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARSH & MCLENNAN AGENCY LLC3 Filed as: PAYNEWEST INSURANCE INC | 390 BRADLEY BLVD RICHLAND, WA 99352 | PREMERA BLUE CROSS | $57K | — | $57K | 6.57% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: PAYNEWEST INSURANCE INC | 501 N RIVERPOINT BLVD #403 SPOKANE, WA 99202 | PREMERA BLUE CROSS | — | $1K | $1K | 0.13% |
| WESTERN STATES INSURANCE AGENCY INC3 | 501 N RIVERPOINT BLVD #403 SPOKANE, WA 99202 | LIFEWISE ASSURANCE COMPANY | — | $4K | $4K | 1.32% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: PAYNEWEST INSURANCE INC | 501 N RIVERPOINT BLVD #403 SPOKANE, WA 99202 | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $23K | $2K | $25K | 12.61% |
| MARK S METTILLE3 | 107 CANDLELIGHT LANE MORRIS, IL 60450 | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $10K | — | $10K | 5.00% |
| ASSUREX3 Filed as: ASSUREX AGENCY INC | 175 S 3RD STREET, SUITE 800 COLUMBUS, OH 43215 | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $855 | — | $855 | 0.43% |
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 | 194 | 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) | 194 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | PREMERA BLUE CROSS | 188 | $869K |
| Dental | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 180 | $201K |
| Vision | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 180 | $201K |
| Life insurance | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 180 | $201K |
| Short-term disability | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 180 | $201K |
| Long-term disability | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 180 | $201K |
| Prescription drug | PREMERA BLUE CROSS | 188 | $869K |
| Stop-loss / reinsurancereinsurance | LIFEWISE ASSURANCE COMPANY | 188 | $296K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 188 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.