| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| FLEXIBLE BENEFITS CORPORATION3 | 6901 6TH AVENUE TACOMA, WA 984061705 | TOKIO MARINE HCC | $17K | — | $17K | 5.00% |
| CAMBRIAN CONSULTING, INC.3 | 16770 NE 79TH STREET SUITE 207 REDMOND, WA 98052 | TOKIO MARINE HCC | $3K | — | $3K | 0.81% |
| THE SEGAL COMPANY3 Filed as: SEGAL COMPANY (WESTERN STATES) INC | 100 MONTEGOMERY ST., STE 500 SAN FRANCISCO, CA 94104 | NATIONAL UNION FIRE INSURANCE COMPANY OF PITTSBURGH, PA | — | $3K | $3K | 3.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| EMPLOYEE BENEFIT ADMINISTRATORS INC EIN 91-1690909 NONE | Direct payment from the plan; Contract Administrator Service code 13 | — | $172K |
| THE SEGAL COMPANY, INC. EIN 94-1503999 NONE | Direct payment from the plan; Consulting (general) Service code 16 | — | $123K |
| TRUSTEED PLANS SERVICE CORPORATION EIN 91-0780588 NONE | Claims processing; Contract Administrator; Direct payment from the plan Service code 12 | — | $119K |
| TURNER, STOEVE & GAGLIARDI, P.S. EIN 91-1282506 NONE | Legal; Direct payment from the plan Service code 29 | — | $93K |
| LINDQUIST LLP EIN 52-2385296 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $62K |
| AMERICAN HEALTH HOLDING INC. EIN 31-1368946 NONE | Other services; Direct payment from the plan Service code 49 | — | $47K |
| REHN & ASSOCIATES NONE | Claims processing; Contract Administrator; Direct payment from the plan Service code 12 | 1322 N POST ST. SPOKANE, WA 99201 | $42K |
| FIRST CHOICE HEALTH NETWORK INC. EIN 91-1272766 NONE | Direct payment from the plan; Other services Service code 49 | — | $41K |
| MARCO CONSULTING GROUP, INC. EIN 36-3555078 NONE | Direct payment from the plan; Investment advisory (plan) Service code 27 | — | $10K |
| PAPER MILL PRINTING NONE | Copying and duplicating; Direct payment from the plan Service code 36 | 14 W INDIANA AVE SPOKANE, WA 99205 | $5K |
| US BANK NA EIN 31-0841368 NONE | Direct payment from the plan; Investment management fees paid directly by plan; Custodial (securities) Service code 19 | — | $5K |
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 | 632 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 66 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 698 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | NATIONAL UNION FIRE INSURANCE COMPANY OF PITTSBURGH, PA | 611 | $96K |
| Dental | DELTA DENTAL OF WASHINGTON | 1,608 | $531K |
| Vision | VISION SERVICE PLAN | 593 | $80K |
| Life insurance | LIFEMAP ASSURANCE COMPANY | 560 | $33K |
| Stop-loss / reinsurancereinsurance | TOKIO MARINE HCC | 0 | $342K |
| Other(2 contracts, 2 carriers) | NATIONAL UNION FIRE INSURANCE COMPANY OF PITTSBURGH, PA | 611 | $129K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,608 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.