| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PROPEL INSURANCE3 | 1201 PACIFIC AVE., #1000 TACOMA, WA 98402 | HCC LIFE INSURANCE COMPANY | $48K | — | $48K | 9.50% |
| INTERREMEDY INSURANCE SERVICES3 Filed as: INTERREMEDY INSURANCE SERVICES, LLC | 315 MONTGOMERY STREET, SUITE 900 SAN FRANCISCO, CA 94104 | HCC LIFE INSURANCE COMPANY | $25K | — | $25K | 5.00% |
| BRADTRUD MIDDLETON INSURANCE3 | P.O. BOX 2940 TACOMA, WA 98401 | LIFEMAP ASSURANCE COMPANY | $3K | $780 | $4K | 7.82% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ZENITH AMERICAN SOLUTIONS EIN 52-1590156 NONE | Direct payment from the plan; Plan Administrator; Accounting (including auditing); Recordkeeping and information management (computing, tabulating, data processing, etc.); Claims processing Service code 10 | — | $332K |
| PREMERA BLUE CROSS NONE | Direct payment from the plan; Claims processing; Other services Service code 12 | 7001 220TH ST SW MOUNTLAKE TERRACE, WA 98403 | $284K |
| AUDIT SERVICES INC. NONE | Legal; Direct payment from the plan Service code 29 | 2123 EASTVIEW PARKWAY CONYERS, GA 30013 | $53K |
| FIRST INTERSTATE BANK EIN 81-6010749 NONE | Direct payment from the plan; Custodial (securities) Service code 19 | — | $49K |
| PROPEL INSURANCE EIN 91-0830024 NONE | Consulting (general); Insurance brokerage commissions and fees; Insurance services Service code 16 | — | $47K |
| TURNER, STOEVE & GAGLIARDI, P.S. EIN 91-1282506 NONE | Legal; Direct payment from the plan Service code 29 | — | $14K |
| ANASTASI, MOORE & MARTIN, PLLC EIN 20-8149084 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $11K |
| PAPERMILL PRINTING NONE | Other services; Direct payment from the plan Service code 49 | 14 W INDIANA AVE SPOKANE, WA 99205 | $9K |
| MILLIMAN EIN 91-0675641 NONE | Actuarial; Direct payment from the plan Service code 11 | — | $8K |
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 | 1,131 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 151 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 1,282 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | LIFEMAP ASSURANCE COMPANY | 1,054 | $54K |
| Stop-loss / reinsurancereinsurance | HCC LIFE INSURANCE COMPANY | 1,252 | $504K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,252 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.