| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | 777 108TH AVENUE NE, SUITE 200 BELLEVUE, WA 98004 | PREMERA BLUE CROSS | $51K | $11K | $63K | 4.28% |
| ARMFIELD HARRISON & THOMAS3 | 600 UNIVERSITY ST STE 1200 SEATTLE, WA 98101 | PREMERA BLUE CROSS | $22K | — | $22K | 1.50% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 777 108TH AVENUE NE, SUITE 200 BELLEVUE, WA 98004 | DELTA DENTAL OF WASHINGTON | $6K | — | $6K | 3.70% |
| ARMFIELD HARRISON & THOMAS3 | 600 UNIVERSITY ST STE 1200 SEATTLE, WA 98101 | DELTA DENTAL OF WASHINGTON | $3K | — | $3K | 1.59% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 777 108TH AVENUE NE, SUITE 200 BELLEVUE, WA 98004 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | — | $5K | 14.17% |
| ARMFIELD HARRISON & THOMAS3 | 600 UNIVERSITY ST STE 1200 SEATTLE, WA 98101 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 5.83% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $2K | $2K | 4.72% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 777 108TH AVE NE STE 200 BELLEVUE, WA 98004 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | — | $4K | 14.15% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $2K | $2K | 6.25% |
| ARMFIELD HARRISON & THOMAS3 | 600 UNIVERSITY ST STE 1200 SEATTLE, WA 98101 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 5.85% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 777 108TH AVENUE NE, SUITE 200 BELLEVUE, WA 98004 | VISION SERVICE PLAN | $818 | — | $818 | 4.93% |
| ARMFIELD HARRISON & THOMAS3 | 600 UNIVERSITY ST STE 1200 SEATTLE, WA 98101 | VISION SERVICE PLAN | $170 | — | $170 | 1.02% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 777 108TH AVE NE STE 200 BELLEVUE, WA 98004 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | — | $1K | 14.15% |
| ARMFIELD HARRISON & THOMAS3 | 600 UNIVERSITY ST STE 1200 SEATTLE, WA 98101 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $480 | — | $480 | 5.85% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $393 | $393 | 4.79% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 777 108TH AVENUE NE, SUITE 200 BELLEVUE, WA 98004 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | — | $1K | 17.28% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD, 11TH FLOOR ROLLING MEADOWS, IL 60008 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $83 | $83 | 1.08% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 777 108TH AVENUE NE, SUITE 200 BELLEVUE, WA 98004 | STANDARD INSURANCE COMPANY | $1K | — | $1K | 24.14% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | STANDARD INSURANCE COMPANY | — | $142 | $142 | 2.50% |
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 | 220 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 221 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | PREMERA BLUE CROSS | 401 | $1.5M |
| Dental | DELTA DENTAL OF WASHINGTON | 401 | $173K |
| Vision | VISION SERVICE PLAN | 216 | $17K |
| Life insurance(3 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 221 | $18K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 221 | $27K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 221 | $34K |
| Prescription drug | PREMERA BLUE CROSS | 401 | $1.5M |
| Other(4 contracts, 3 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 221 | $19K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 401 | — |
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 compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.