| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ALLIANT INSURANCE SERVICES, INC. Filed as: ALLIANT INSURANCE SERVICES INC. | 1420 5TH AVE 15TH FLOOR SEATTLE, WA 98101 | LIFEMAP ASSURANCE COMPANY | $961 | — | $961 | 3.48% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| MEDICAL REHABILITATION CONSULTANTS EIN 91-1448997 NONE | Other services Service code 49 | — | $337K |
| ZENITH AMERICAN SOLUTIONS, INC. EIN 52-1590516 NONE | Direct payment from the plan; Claims processing; Accounting (including auditing); Recordkeeping and information management (computing, tabulating, data processing, etc.); Plan Administrator Service code 10 | — | $329K |
| FIRST CHOICE HEALTH NETWORK EIN 91-1272766 NONE | Other services; Direct payment from the plan Service code 49 | — | $71K |
| ALLIANT INSURANCE SERVICES EIN 33-0785439 NONE | Consulting (general) Service code 16 | — | $64K |
| REINHART BOERNER VAN DEUREN S.C. EIN 41-2981000 NONE | Legal; Direct payment from the plan Service code 29 | — | $64K |
| MEDIMPACT HEALTHCARE SYSTEMS, INC. EIN 33-0567651 NONE | Other services; Claims processing Service code 12 | — | $46K |
| ANASTASI, MOORE & MARTIN, PLLC EIN 20-8149084 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $31K |
| LAWTON PRINTING SERVICES NONE | Direct payment from the plan; Other services Service code 49 | 4111 E MISSION AVENUE SPOKANE, WA 99202 | $19K |
| WELLS FARGO BANK, N.A EIN 94-1347393 NONE | Custodial (other than securities); Custodial (securities); Direct payment from the plan; Trustee (bank, trust company, or similar financial institution) Service code 18 | — | $14K |
| CLEARHEALTH STRATEGIES NONE | Other services Service code 49 | 9990 COCONUT ROAD SUITE 301 BONITA SPRINGS, FL 34135 | $12K |
| HEALTH RISK STRATEGIES, LLC NONE | Direct payment from the plan; Consulting (general); Actuarial Service code 11 | 6804 BRITTANY ROAD EDINA, MI 55435 | $10K |
| ASSURED PARTNERS OF WA, LLC EIN 38-3942963 NONE | Direct payment from the plan; Insurance services Service code 23 | — | $7K |
| HILDI INC. NONE | Actuarial; Direct payment from the plan Service code 11 | 14852 SCENIC HEIGHTS RD, SUITE 205 EDEN PRAIRIE, MN 55344 | $6K |
| MULTIPLAN, INC. NONE | Direct payment from the plan; Other services Service code 49 | 115 5TH AVENUE NEW YORK, NY 10003 | $5K |
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 | 874 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 16 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 890 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | VISION SERVICE PLAN | 785 | $57K |
| Life insurance | LIFEMAP ASSURANCE COMPANY | 863 | $28K |
| Stop-loss / reinsurancereinsurance | HCC LIFE INSURANCE COMPANY | 1,217 | $743K |
| Other | LIFEMAP ASSURANCE COMPANY | 863 | $28K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,217 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.