| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ALLIANT INSURANCE SERVICES, INC. Filed as: ALLIANT INSURANCE SERVICES | 818 W RIVERSIDE AVE STE 800 SPOKANE, WA 99201 | PREMERA BLUE CROSS | — | $4K | $4K | 0.16% |
| ALLIANT INSURANCE SERVICES, INC. Filed as: ALLIANT INSURANCE SERVICES | 701 B ST. STE 600 SAN DIEGO, CA 921018156 | LIFEWISE ASSURANCE COMPANY | $37K | — | $37K | 5.75% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| PREMERA BLUE CROSS EIN 91-0499247 | Other services; Insurance services Service code 23 | PO BOX 91059 SEATTLE, WA 98111 | $8K |
| ESI EIN 22-3461740 | Insurance services Service code 23 | — | $4K |
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 | 186 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 6 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 192 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | PREMERA BLUE CROSS | 192 | $2.5M |
| Dental | DELTA DENTAL OF WASHINGTON | 198 | $225K |
| Vision | PREMERA BLUE CROSS | 192 | $2.5M |
| Prescription drug | PREMERA BLUE CROSS | 192 | $2.5M |
| Stop-loss / reinsurancereinsurance | LIFEWISE ASSURANCE COMPANY | 193 | $638K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 198 | — |
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.