| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| KEVIN OVERBEY3 Filed as: KEVIN T. OVERBEY | 720 OLIVE WAY, SUITE 1700 SEATTLE, WA 98101 | BLUE CROSS OF CALIFORNIA | $53K | — | $53K | 3.61% |
| ALLIANT INSURANCE SERVICES, INC.3 | 1420 5TH AVENUE, SUITE 1500 SEATTLE, WA 98101 | BLUE CROSS OF CALIFORNIA | $5K | — | $5K | 0.34% |
| ALLIANT INSURANCE SERVICES, INC.3 | 720 OLIVE WAY, SUITE 1700 SEATTLE, WA 98101 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $16K | — | $16K | 4.46% |
| KEVIN OVERBEY3 Filed as: KEVIN T. OVERBEY | 525 WEST COMSTOCK SEATTLE, WA 98119 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $12K | — | $12K | 3.45% |
| ALLIANT INSURANCE SERVICES, INC.3 | 701 B STREET, 6TH FLOOR SAN DIEGO, CA 92101 | VISION SERVICE PLAN | $2K | — | $2K | 4.13% |
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 | 293 | 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) | 293 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS OF CALIFORNIA | 269 | $1.5M |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 293 | $348K |
| Vision | VISION SERVICE PLAN | 270 | $39K |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 293 | $348K |
| Long-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 293 | $348K |
| Prescription drug | BLUE CROSS OF CALIFORNIA | 269 | $1.5M |
| Other(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 293 | $357K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 293 | — |
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.