| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF WASHINGTON, INC. | 1501 FOURTH AVENUE, SUITE 2400 SEATTLE, WA 98101 | ASURIS NORTHWEST HEALTH | — | — | $0 | 0.00% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF WASHINGTON, INC. | 1501 FOURTH AVENUE, SUITE 2400 SEATTLE, WA 98101 | REGENCE BLUESHIELD | $5K | — | $5K | 11.43% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF WASHINGTON, INC. | 1501 FOURTH AVENUE, SUITE 2400 SEATTLE, WA 98101 | ASURIS NORTHWEST HEALTH | $2K | — | $2K | 11.06% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| REGENCE BLUESHIELD EIN 91-0282080 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.); Claims processing; Copying and duplicating; Participant communication; Direct payment from the plan; Other commissions; Accounting (including auditing); Contract Administrator; Float revenue; Recordkeeping fees Service code 10 | — | $1.2M |
| BROWN & BROWN OF WA DBA DIMARTINO EIN 91-1473578 NONE | Insurance brokerage commissions and fees; Consulting (general); Recordkeeping and information management (computing, tabulating, data processing, etc.); Insurance services; Finders' fees / placement fees; Consulting fees; Insurance agents and brokers; Direct payment from the plan Service code 15 | — | $620K |
| BENEFIT SOLUTIONS, INC. EIN 91-1603312 NONE | Accounting (including auditing); Other commissions; Direct payment from the plan; Copying and duplicating; Recordkeeping fees; Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.); Participant communication Service code 10 | — | $256K |
| MCKENZIE ROTHWELL BARLOW & COUGHRAN EIN 91-0889948 NONE | Consulting (general); Legal; Direct payment from the plan Service code 16 | — | $19K |
| SCHOEDEL & SCHOEDEL, CPAS, PLLC EIN 91-0614823 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $16K |
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 | 1,555 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 191 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 1,746 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 2 carriers) | REGENCE BLUESHIELD | 138 | $1.4M |
| Dental | DELTA DENTAL OF WASHINGTON | 2,725 | $1.1M |
| Vision(2 contracts, 2 carriers) | REGENCE BLUESHIELD | 25 | $58K |
| Prescription drug(3 contracts, 2 carriers) | REGENCE BLUESHIELD | 138 | $1.3M |
| Stop-loss / reinsurancereinsurance | LIFEMAP ASSURANCE COMPANY | 5,308 | $1.5M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 5,308 | — |
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."
Broker comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.