| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ASSUREDPARTNERS3 | 1325 FOURTH AVE SUITE 2100 SEATTLE, WA 98101 | KAISER PERMANENTE | $21K | — | $21K | 1.16% |
| ASSUREDPARTNERS3 | 1325 4TH AVE., STE. 2100 SEATTLE, WA 98101 | DELTA DENTAL OF WASHINGTON | $13K | — | $13K | 5.09% |
| ASSUREDPARTNERS3 Filed as: ASSUREDPARTNERS OF WASHINGTON LLC | 1325 4TH AVE STE 2100 SEATTLE, WA 98101 | CONTINENTAL AMERICAN INSURANCE COMPANY | $8K | — | $8K | 10.83% |
| TIMOTHY W HELD3 | GIG HARBOR GIG HARBOR, WA 98239 | CONTINENTAL AMERICAN INSURANCE COMPANY | $6K | — | $6K | 8.59% |
| BARRY G WIEBE3 | 4379 SUNDOWN VIEW TER BELLINGHAM, WA 98226 | CONTINENTAL AMERICAN INSURANCE COMPANY | $2K | — | $2K | 2.10% |
| KYONG H. GOINS3 Filed as: KYONG H GOINS | 2931 1ST AVENUE #A SEATTLE, WA 98134 | CONTINENTAL AMERICAN INSURANCE COMPANY | $910 | — | $910 | 1.25% |
| JEFF DALABA3 Filed as: JEFF CLACK | 4425 HARBOR COUNTRY DRIVE APT L85 GIG HARBOR, WA 98335 | CONTINENTAL AMERICAN INSURANCE COMPANY | $864 | — | $864 | 1.19% |
| DAVID BRUNSON3 | 5378 DUSTY LANE BURLINGTON, WA 98233 | CONTINENTAL AMERICAN INSURANCE COMPANY | $464 | — | $464 | 0.64% |
| LISA R PETERS3 | 1932 A COLLEGE WAY SUITE B MOUNT VERNON, WA 98273 | CONTINENTAL AMERICAN INSURANCE COMPANY | $249 | — | $249 | 0.34% |
| ASSUREDPARTNERS3 | 1325 4TH AVE STE 2100 SEATTLE, WA 98101 | AMERITAS LIFE INSURANCE COMPANY | $1K | — | $1K | 5.00% |
| ASSUREDPARTNERS3 | 1325 4TH AVE. STE. 2100 SEATTLE, WA 98101 | METROPOLITAN LIFE INSURANCE COMPANY | $3K | $78 | $3K | 20.26% |
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 | 324 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 5 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 329 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER PERMANENTE | 324 | $1.9M |
| Dental | DELTA DENTAL OF WASHINGTON | 312 | $248K |
| Vision | AMERITAS LIFE INSURANCE COMPANY | 272 | $28K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 31 | $17K |
| Short-term disability(2 contracts, 2 carriers) | CONTINENTAL AMERICAN INSURANCE COMPANY | 213 | $90K |
| Prescription drug | KAISER PERMANENTE | 324 | $1.9M |
| Other(2 contracts, 2 carriers) | CONTINENTAL AMERICAN INSURANCE COMPANY | 213 | $90K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 324 | — |
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.