| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES | 818 WEST RIVERSIDE, SUITE 800 SPOKANE, WA 99201 | HCC LIFE INSURANCE COMPANY | — | $11K | $11K | 3.00% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICE | 701 B ST 6TH FLOOR SAN DIEGO, CA 92101 | LIFE INSURANCE COM OF NORTH AMERICA | $10K | — | $10K | 9.87% |
| COTTER CONSULTING & BENEFITS INC3 | 13526 160TH AVE REDMOND, WA 98052 | AFLAC | $2K | $147 | $2K | 3.52% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL INC | PO BOX 203588 DALLAS, TX 75320 | AFLAC | $831 | — | $831 | 1.66% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICE | 701 B ST 6TH FLOOR SAN DIEGO, CA 92101 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $558 | — | $558 | 2.40% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HEALTHCOMP ADMINISTRATORS EIN 77-0385729 CONTRACT ADMIN | Contract Administrator; Claims processing; Direct payment from the plan Service code 12 | — | $243K |
| FIRST CHOICE HLTH NTWK EIN 91-1272766 PPO VENDOR | Direct payment from the plan; Other fees Service code 50 | — | $26K |
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 | 279 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 5 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 284 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance(3 contracts, 3 carriers) | LIFE INSURANCE COM OF NORTH AMERICA | 287 | $230K |
| Long-term disability | LIFE INSURANCE COM OF NORTH AMERICA | 287 | $76K |
| Stop-loss / reinsurancereinsurance | HCC LIFE INSURANCE COMPANY | 280 | $380K |
| Other(2 contracts, 2 carriers) | LIFE INSURANCE COM OF NORTH AMERICA | 172 | $124K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 287 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.