| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | 777 108TH AVENUE NE, SUITE 200 BELLEVUE, WA 98004 | REGENCE BLUESHIELD | $43K | $2K | $45K | 4.75% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 10900 NE 8TH STREET, SUITE 750 BELLEVUE, WA 98004 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $3K | $0 | $3K | 12.54% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $0 | $749 | $749 | 2.86% |
| VERUS INSURANCE SERVICES, LLC3 | 4170 DOUGLAS BOULEVARD, SUITE 100 GRANITE BAY, CA 95746 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $644 | $0 | $644 | 2.46% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN & OTHER AGENTS | 2106 PACIFIC AVENUE, SUITE 501 SEATTLE, WA 98402 | AFLAC | $462 | $0 | $462 | 3.62% |
| DVG INSURANCE, INC.3 | 6512 18TH AVENUE NW SEATTLE, WA 98117 | AFLAC | $234 | $0 | $234 | 1.83% |
| KIRSTEN J. CONRAD3 | 14590 CAVALLI ROAD SE OLALLA, WA 98359 | AFLAC | $143 | $0 | $143 | 1.12% |
| ELIZABETH D PEARSON3 Filed as: ELIZABETH D. PEARSON | 4609 103RD LANE NE KIRKLAND, WA 98033 | AFLAC | $126 | $0 | $126 | 0.99% |
| ROSELLINI CONSULTING SERVICES LLC3 Filed as: ROSELLINI CONSULTING SERVICES, LLC | 3728 204TH STREET SW APARTMENT D303 LYNNWOOD, WA 98036 | AFLAC | $109 | $0 | $109 | 0.85% |
| DONALD SIZEMORE3 | 1136 EAST 6TH STREET PORT ANGELES, WA 98362 | AFLAC | $70 | $0 | $70 | 0.55% |
| MATTHEW G BERGER Filed as: MATTHEW A. BUMALA | 11504 NW 30TH COURT VANCOUVER, WA 98685 | AFLAC | $58 | $0 | $58 | 0.45% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | VISION SERVICE PLAN | $579 | — | $579 | 7.35% |
| VERUS INSURANCE SERVICES, LLC3 Filed as: VERUS INSURANCE SERVICES | 9700 VILLAGE CENTER DRIVE SUITE 200 GRANITE BAY, CA 95746 | VISION SERVICE PLAN | $128 | — | $128 | 1.62% |
| EMPLOYEE NAVIGATOR, LLC3 | 7979 OLD GEORGETOWN ROAD, SUITE 300 BETHESDA, MD 20814 | VISION SERVICE PLAN | $13 | — | $13 | 0.17% |
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 | 106 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 108 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | REGENCE BLUESHIELD | 138 | $948K |
| Vision | VISION SERVICE PLAN | 93 | $8K |
| Life insurance(2 contracts, 2 carriers) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 106 | $39K |
| Short-term disability | AFLAC | 16 | $13K |
| Prescription drug | REGENCE BLUESHIELD | 138 | $948K |
| Other(2 contracts, 2 carriers) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 106 | $39K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 138 | — |
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 compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.