| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WHITFIELDS UNITED INSURANCE AGENCIE3 Filed as: WHITFIELDS UNITED INS. AGENCIES INC | PO BOX 833 AUBURN, WA 98071 | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON OPTIONS, INC. | $15K | $0 | $15K | 2.95% |
| WHITFIELDS UNITED INSURANCE AGENCIE3 Filed as: WHITFIELDS UNITED INS. AGENCIES INC | PO BOX 833 AUBURN, WA 98071 | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON | $7K | $0 | $7K | 3.06% |
| WHITFIELDS UNITED INSURANCE AGENCIE3 Filed as: WHITFIELDS UNITED INS. AGENCIES INC | PO BOX 833 AUBURN, WA 98071 | PRINCIPAL LIFE INSURANCE COMPANY | $12K | $3K | $15K | 9.93% |
| LEAVITT GROUP3 Filed as: LEAVITT GROUP AGENCY ASSOC. LLC | PO BOX 130 CEDAR CITY, UT 84721 | PRINCIPAL LIFE INSURANCE COMPANY | $0 | $2K | $2K | 1.08% |
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 | 144 | 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) | 144 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON OPTIONS, INC. | 113 | $748K |
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 239 | $151K |
| Vision | PRINCIPAL LIFE INSURANCE COMPANY | 239 | $151K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 239 | $151K |
| Long-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 239 | $151K |
| Prescription drug(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON OPTIONS, INC. | 113 | $748K |
| Other | PRINCIPAL LIFE INSURANCE COMPANY | 239 | $151K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 239 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.