| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | 777 108TH AVENUE NE, SUITE 200 BELLEVUE, WA 98004 | PREMERA BLUE CROSS | $2K | $0 | $2K | 3.12% |
| LIBERTY BENEFITS GROUP LLC3 | 4100 194TH STREET SW, SUITE 380 LYNWOOD, WA 98038 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $5K | $0 | $5K | 11.29% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 777 108TH AVENUE NE, SUITE 200 BELLEVUE, WA 98004 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | $0 | $3K | 6.07% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 WEST GOLF ROAD, 11TH FLOOR ROLLING MEADOWS, IL 60008 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $370 | $370 | 0.79% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 777 108TH AVENUE NE, SUITE 200 BELLEVUE, WA 98004 | VISION SERVICE PLAN | $832 | $0 | $832 | 6.73% |
| LIBERTY BENEFITS GROUP LLC3 | 4100 194TH STREET SW, SUITE 380 LYNWOOD, WA 98038 | UNITEDHEALTHCARE INSURANCE COMPANY | $302 | $0 | $302 | 13.32% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 777 108TH AVENUE NE, SUITE 200 BELLEVUE, WA 98004 | UNITEDHEALTHCARE INSURANCE COMPANY | $189 | $0 | $189 | 8.33% |
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 | 193 | 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) | 193 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | PREMERA BLUE CROSS | 0 | $58K |
| Vision | VISION SERVICE PLAN | 135 | $12K |
| Life insurance(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 61 | $49K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 61 | $47K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 61 | $47K |
| Other(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 61 | $49K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 135 | — |
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.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.