| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF WASHINGTON | DBA DIMARTINO ASSOCIATES 1301 FIFTH AVE, SUITE 3701 SEATTLE, WA 98101 | LIFEWISE ASSURANCE COMPANY | $5K | — | $5K | 0.98% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF WASHINGTON | 1501 FOURTH AVENUE STE 400 SEATTLE, WA 98101 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $30K | $2K | $32K | 20.04% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN AND BROWN OF WASHINGTON | 1501 FOURTH AVENUE STE 2400 SEATTLE, WA 98101 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | $259 | $3K | 18.77% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF WASHINGTON | 1501 FOURTH AVENUE STE 2400 SEATTLE, WA 98101 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $647 | $75 | $722 | 18.80% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| PREMERA BLUE CROSS EIN 91-0499247 NONE | Contract Administrator; Direct payment from the plan; Claims processing; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | — | $279K |
| BROWN AND BROWN OF WA EIN 91-0378940 NONE | Consulting (general); Direct payment from the plan; Insurance agents and brokers Service code 16 | — | $107K |
| WELFARE AND PENSION ADMIN SERVICES EIN 91-1363171 NONE | Direct payment from the plan; Plan Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.); Other services Service code 14 | — | $64K |
| BENEFIT PLANS ADMIN SERVICES INC EIN 16-1503696 NONE | Investment advisory (plan); Claims processing; Investment management fees paid directly by plan; Trustee (bank, trust company, or similar financial institution); Sub-transfer agency fees; Recordkeeping and information management (computing, tabulating, data processing, etc.); Custodial (other than securities) Service code 12 | — | $59K |
| MCKENZIE, ROTHWELL, BARLOW, P.S. EIN 91-0889948 NONE | Legal; Direct payment from the plan Service code 29 | — | $15K |
| ANASTASI, MOORE & MARTIN, PLLC EIN 20-8149084 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $12K |
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 | 333 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 132 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 465 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF WASHINGTON | 368 | $456K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 307 | $13K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 307 | $158K |
| Stop-loss / reinsurancereinsurance | LIFEWISE ASSURANCE COMPANY | 391 | $533K |
| Other | LIFE INSURANCE COMPANY OF NORTH AMERICA | 307 | $4K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 391 | — |
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."
No prospect flags tripped on this filing.