| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 95287 CHICAGO, IL 60694 | PREMERA BLUE CROSS | $0 | $12K | $12K | 0.91% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 777 108TH AVENUE NE, SUITE 200 BELLEVUE, WA 98004 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $5K | $0 | $5K | 10.39% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD, 11TH FLOOR ROLLING MEADOWS, IL 60008 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $504 | $504 | 1.03% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 95287 CHICAGO, IL 60694 | VISION SERVICE PLAN | $703 | $0 | $703 | 7.35% |
| PAMELA HOTTINGER3 | 1610 E LAKE SAMMAMISH PLACE SE SAMMAMISH, WA 98075 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $6 | — | $6 | 10.53% |
| BRIDGET ZUNIGA3 | 14608 WEST 62ND STREET SHAWNEE, KS 66216 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $4 | $0 | $4 | 7.02% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 777 108TH AVENUE BELLEVUE, WA 98004 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $3 | $0 | $3 | 5.26% |
| ROBERT WILLIAM PLATTE3 | 15221 227TH AVENUE NORTH WOODINVILLE, WA 98077 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2 | $0 | $2 | 3.51% |
| ELIZABETH BETTRIDGE3 Filed as: ELIZABETH BETTRIDGE AND OTHER AGENT | 22211 6TH AVENUE SOUTH DES MOINES, WA 98198 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2 | $0 | $2 | 3.51% |
| J WILSON AGENCY LLC3 Filed as: J WILSON AGENCY, LLC | 15518 SE 133RD STREET RENTON, WA 98059 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1 | $0 | $1 | 1.75% |
| CALEB ANTHONY LAW3 | 19807 2ND DRIVE SE BOTHELL, WA 98012 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 1.75% |
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 | 88 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 88 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | PREMERA BLUE CROSS | 176 | $1.3M |
| Dental | PREMERA BLUE CROSS | 176 | $1.3M |
| Vision(2 contracts, 2 carriers) | PREMERA BLUE CROSS | 176 | $1.3M |
| Life insurance(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 84 | $49K |
| Short-term disability(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 84 | $49K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 84 | $49K |
| Prescription drug | PREMERA BLUE CROSS | 176 | $1.3M |
| Other(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 84 | $49K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 176 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.