| 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 | — | $7K | $7K | 1.27% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF WASHINGTON | DBA DIMARTINO ASSOCIATES 1301 FIFTH AVE, SUITE 3701 SEATTLE, WA 98101 | STANDARD INSURANCE COMPANY | $35K | — | $35K | 16.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| PREMERA BLUE CROSS EIN 91-0499247 NONE | Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.); Direct payment from the plan; Claims processing Service code 12 | — | $171K |
| WELFARE AND PENSION ADMIN SERVICES EIN 91-1363171 NONE | Plan Administrator; Other services; Recordkeeping and information management (computing, tabulating, data processing, etc.); Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $149K |
| BROWN AND BROWN OF WA EIN 91-0378940 NONE | Direct payment from the plan; Insurance agents and brokers; Consulting (general) Service code 16 | — | $116K |
| SPOKANE INTERNAL MEDICINE NONE | Direct payment from the plan; Other fees Service code 50 | 1215 N MCDONALD ROAD SUITE 101 SPOKANE VALLEY, WA 99216 | $82K |
| BENEFIT PLANS ADMIN SERVICES INC EIN 16-1503696 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.); Trustee (bank, trust company, or similar financial institution); Custodial (other than securities); Sub-transfer agency fees; Investment advisory (plan); Investment management fees paid directly by plan; Claims processing Service code 12 | — | $68K |
| INNOVATIVE CARE MANAGEMENT EIN 93-1087669 NONE | Direct payment from the plan; Other services Service code 49 | — | $32K |
| ANASTASI, MOORE & MARTIN, PLLC EIN 20-8149084 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $13K |
| MCKENZIE, ROTHWELL, BARLOW, P.S. EIN 91-0889948 NONE | Legal; Direct payment from the plan Service code 29 | — | $10K |
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 | 337 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 147 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 484 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF WASHINGTON | 414 | $481K |
| Life insurance | STANDARD INSURANCE COMPANY | 330 | $216K |
| Long-term disability | STANDARD INSURANCE COMPANY | 330 | $216K |
| Stop-loss / reinsurancereinsurance | LIFEWISE ASSURANCE COMPANY | 434 | $532K |
| Other | STANDARD INSURANCE COMPANY | 330 | $216K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 434 | — |
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.