| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MADDOCK & ASSOCIATES LLC3 Filed as: MADDOCK & ASSOCIATES | 1407 WILLOW RD E TACOMA, WA 98424 | REGENCE BLUE SHIELD | — | $4K | $4K | 0.05% |
| BENEFIT CONSULTANTS NORTHWEST INC3 | 1717 FRANCIS AVE SPOKANE, WA 99205 | REGENCE BLUE SHIELD | — | $4K | $4K | 0.04% |
| BRATRUD MIDDLETON INS BROKERS INC3 | 1201 PACIFIC AVENUE SUITE 1000 TACOMA, WA 98402 | REGENCE BLUE SHIELD | — | $2K | $2K | 0.02% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE INC | 200 GALLERIA PKWY #1950 ATLANTA, GA 30339 | REGENCE BLUE SHIELD | — | $1K | $1K | 0.02% |
| GROUP SOLUTIONS NORTHWEST, LLC3 Filed as: GROUP SOLUTIONS NORTHWEST LLC | 429 29TH ST PUYALLUP, WA 98372 | REGENCE BLUE SHIELD | — | $1K | $1K | 0.01% |
| ASSOCIATION BENEFITS CO3 Filed as: ASSOCIATION BENEFITS CORPORATION | 1415 28TH STREET SUITE 100 WEST DES MOINES, IA 50266 | REGENCE BLUE SHIELD | — | $1K | $1K | 0.01% |
| SUPERIOR INSURANCE SERVICE, INC.3 Filed as: SUPERIOR INSURANCE SERVICE INC | 817 HARVEY RD AUBURN, WA 98002 | REGENCE BLUE SHIELD | — | $1K | $1K | 0.01% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF WASHINGTON | 1501 4TH AVE SUITE 2400 SEATTLE, WA 98101 | REGENCE BLUE SHIELD | — | $894 | $894 | 0.01% |
| ALLIANT INSURANCE SERVICES, INC.3 | 1420 5TH AVE SUITE 1500 SEATTLE, WA 98101 | REGENCE BLUE SHIELD | — | $820 | $820 | 0.01% |
| BRINK, BRENDA M3 | 1425 LAKESIDE COURT YAKIMA, WA 98902 | REGENCE BLUE SHIELD | — | $800 | $800 | 0.01% |
| DIAMOND BENEFITS INSURANCE SERVICES3 | 19125 NORTHCREEK PARKWAY SUITE 120 BOTHELL, WA 98011 | REGENCE BLUE SHIELD | — | $800 | $800 | 0.01% |
| BARKER & ASSOCIATES LLC3 | 1650 ENGLISH AVE CASPER, WY 82601 | REGENCE BLUE SHIELD | — | $650 | $650 | 0.01% |
| J D PHILLIPS & ASSOC. INC3 | 1292 E AXTON RD BELLINGHAM, WA 98226 | REGENCE BLUE SHIELD | — | $650 | $650 | 0.01% |
| PAYCHEX INSURANCE AGENCY, INC.3 Filed as: PAYCHEX INSURANCE AGENCY | 150 SAWGRASS DR ROCHESTER, NY 14620 | REGENCE BLUE SHIELD | — | $650 | $650 | 0.01% |
| STACY MICHELMAN, GAIL A3 | 1203 250TH AVE NE SAMMAMISH, WA 98074 | REGENCE BLUE SHIELD | — | $650 | $650 | 0.01% |
| ARDENT BENEFITS CORPORATION3 | 6018 50TH AVE NE SEATTLE, WA 98115 | REGENCE BLUE SHIELD | — | $500 | $500 | 0.01% |
| REX HEAD3 | 1202 E SPRAGUE AVE SPOKANE, WA 99202 | REGENCE BLUE SHIELD | — | $500 | $500 | 0.01% |
| MCGREGOR INSURANCE AGENCY, INC.3 Filed as: MCGREGOR INSURANCE AGENCY | 83 N MARBLE STREET MCGREGOR, MN 55760 | REGENCE BLUE SHIELD | — | $500 | $500 | 0.01% |
| AMERICAN UNDERWRITERS INSURANCE INC3 | 6429 S TACOMA WAY TACOMA, WA 98409 | REGENCE BLUE SHIELD | — | $400 | $400 | 0.00% |
| PACIFIC NW INSURANCE3 | 5612 LAKE WASHINGTON BLVD NE #100C KIRKLAND, WA 98033 | REGENCE BLUE SHIELD | — | $400 | $400 | 0.00% |
| R.L. EVANS COMPANY, INC.3 Filed as: R L EVANS COMPANY INC | 3535 FACTORIA BLVD SE #120 BELLEVUE, WA 98006 | REGENCE BLUE SHIELD | — | $400 | $400 | 0.00% |
| SOUND BENEFIT SERVICES INC3 | 6628 212TH ST SW #112 LYNNWOOD, WA 98036 | REGENCE BLUE SHIELD | — | $350 | $350 | 0.00% |
| MICHAEL BENZIKRY & ASSOC.3 | 9311 93RD AVE SE #105 MERCER ISLAND, WA 98040 | REGENCE BLUE SHIELD | — | $350 | $350 | 0.00% |
| STREICH FINANCIAL SERV.3 | 11419 19TH AVE SE EVERETT, WA 98208 | REGENCE BLUE SHIELD | — | $350 | $350 | 0.00% |
| BELLEVUE BENEFIT SERVICES INC3 | 15375 SE 30TH PL BELLEVUE, WA 98007 | REGENCE BLUE SHIELD | — | $300 | $300 | 0.00% |
| REETZ INSURANCE3 | 835 E 2ND ST. PORT ANGELES, WA 98362 | REGENCE BLUE SHIELD | — | $300 | $300 | 0.00% |
| DOUGLAS A WOHLMAN INC.3 Filed as: T E DOUGLAS CORPORATION | 144 RAILROAD AVE #236 EDMONDS, WA 98020 | REGENCE BLUE SHIELD | — | $250 | $250 | 0.00% |
| CONOVER INSURANCE SERVICES LLC3 | 3911 CASTLEVALE ROAD SUITE 201 YAKIMA, WA 98909 | REGENCE BLUE SHIELD | — | $200 | $200 | 0.00% |
| HEALTHY FAMILY INSURANCE LLC3 | S MAIN ST DEER PARK, WA 99006 | ASURIS NORTHWEST HEALTH | — | $450 | $450 | 0.04% |
| CONOVER INSURANCE SERVICES LLC3 | 125 N 50TH AVE YAKIMA, WA 98909 | ASURIS NORTHWEST HEALTH | — | $120 | $120 | 0.01% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| DIMARTINO ASSOCIATES EIN 91-0378940 NONE | Other commissions; Insurance agents and brokers; Direct payment from the plan Service code 22 | — | $368K |
| BENEFIT SOLUTIONS INC. EIN 91-1603312 NONE | Direct payment from the plan; Plan Administrator Service code 14 | — | $247K |
| WASHINGTON AUTO INDUSTRY ASSOC. NONE | Direct payment from the plan; Other services Service code 49 | PO BOX 12690 MILL CREEK, WA 98082 | $60K |
| ANASTASI, MOORE & MARTIN, PLLC EIN 20-8149084 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $13K |
| MCKENZIE ROTHWELL BARLOW & COUGHRAN NONE | Legal; Direct payment from the plan Service code 29 | 1325 4TH STREET SEATTLE, WA 98101 | $9K |
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 | 1,591 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 1,591 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | REGENCE BLUE SHIELD | 1,924 | $12.6M |
| Dental | DELTA DENTAL | 158 | $140K |
| Vision | VISION SERVICE PLAN | 947 | $57K |
| Life insurance | LIFEMAP ASSURANCE COMPANY | 1,659 | $42K |
| Prescription drug(2 contracts, 2 carriers) | REGENCE BLUE SHIELD | 1,924 | $10.4M |
| Other | LIFEMAP ASSURANCE COMPANY | 1,659 | $42K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,924 | — |
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.
Multiple-employer welfare arrangement. Specific regulatory and compliance context; specific consultant niche.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.