| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| INSURANCE OFFICE OF AMERICA3 Filed as: INSURANCE OFFICE OF AMERICA INC | PO BOX 387 EVERETT, WA 982060387 | KAISER FOUNDATION HEALTH PLAN, INC. | $49K | — | $49K | 3.00% |
| INSURANCE OFFICE OF AMERICA3 Filed as: INSURANCE OFFICE OF AMERICA INC | PO BOX 387 EVERETT, WA 982060387 | KAISER FOUNDATION HEALTH PLAN, INC. | $28K | — | $28K | 2.79% |
| ERIC M SILVERMAN3 | 1423 MARTIN MEADOWS DR FALLSTON, MD 21047 | MUTUAL OF OMAHA LIFE INSURANCE COMPANY | $27K | $2K | $29K | 17.69% |
| PSG WASHINGTON INC3 | PO BOX 387 EVERETT, WA 98206 | MUTUAL OF OMAHA LIFE INSURANCE COMPANY | $7K | — | $7K | 4.60% |
| INSURANCE OFFICE OF AMERICA3 Filed as: INSURANCE OFFICE OF AMERICA INC | 1855 W STATE ROAD #434 LONGWOOD, FL 32750 | MUTUAL OF OMAHA LIFE INSURANCE COMPANY | $7K | — | $7K | 4.15% |
| NATIONAL BENEFIT PARTNER WEST LLC3 | 99 WOOD AVE S STE 501 ISELIN, NJ 08830 | MUTUAL OF OMAHA LIFE INSURANCE COMPANY | $0 | $3K | $3K | 2.00% |
| ERIC M SILVERMAN3 | 1423 MARTIN MEADOWS DR FALLSTON, MD 21047 | MUTUAL OF OMAHA LIFE INSURANCE COMPANY | $12K | $1K | $13K | 14.31% |
| INSURANCE OFFICE OF AMERICA3 Filed as: INSURANCE OFFICE OF AMERICA INC | 1855 W STATE ROAD #434 LONGWOOD, FL 32750 | MUTUAL OF OMAHA LIFE INSURANCE COMPANY | $3K | — | $3K | 3.51% |
| PSG WASHINGTON INC3 | PO BOX 387 EVERETT, WA 98206 | MUTUAL OF OMAHA LIFE INSURANCE COMPANY | $3K | — | $3K | 3.48% |
| NATIONAL BENEFIT PARTNER WEST LLC3 | 99 WOOD AVE S STE 501 ISELIN, NJ 08830 | MUTUAL OF OMAHA LIFE INSURANCE COMPANY | $0 | $2K | $2K | 2.00% |
| PSG WASHINGTON INC3 | PO BOX 387 EVERETT, VT 98206 | VISION SERVICE PLAN | $2K | — | $2K | 2.58% |
| INSURANCE OFFICE OF AMERICA3 Filed as: INSURANCE OFFICE OF AMERICA INC | 1855 W STATE RD #434 LONGWOOD, FL 32750 | VISION SERVICE PLAN | $2K | — | $2K | 2.42% |
| ERIC M SILVERMAN3 | 1423 MARTIN MEADOWS DR FALLSTON, MD 21047 | MUTUAL OF OMAHA LIFE INSURANCE COMPANY | $14K | $1K | $15K | 17.59% |
| PSG WASHINGTON INC3 | PO BOX 387 EVERETT, WA 98206 | MUTUAL OF OMAHA LIFE INSURANCE COMPANY | $4K | — | $4K | 4.54% |
| INSURANCE OFFICE OF AMERICA ONTARIO3 Filed as: INSURANCE OFFICE OF AMERICA INA | 1855 W STATE ROAD #434 LONGWOOD, FL 32750 | MUTUAL OF OMAHA LIFE INSURANCE COMPANY | $4K | — | $4K | 4.21% |
| NATIONAL BENEFIT PARTNER WEST LLC3 | 99 WOOD AVE S STE 501 ISELIN, NJ 08830 | MUTUAL OF OMAHA LIFE INSURANCE COMPANY | $0 | $2K | $2K | 2.00% |
| PSG WASHINGTON INC3 | 2828 COLBY AVENUE STE 404 EVERETT, WA 98201 | KAISER FOUNDATION HEALTH PLAN, INC. | $1K | — | $1K | 1.54% |
| ACRISURE LLC3 Filed as: ORION RISK MGMT INS SERVICES | 1800 QUAIL STREET SUITE 110 NEWPORT BEACH, CA 92660 | KAISER FOUNDATION HEALTH PLAN, INC. | $1K | — | $1K | 1.41% |
| ERIC M SILVERMAN3 | 1423 MARTIN MEADOWS DR FALLSTON, MD 21047 | MUTUAL OF OMAHA LIFE INSURANCE COMPANY | $9K | $960 | $10K | 14.31% |
| PSG WASHINGTON INC3 | PO BOX 387 EVERETT, WA 98206 | MUTUAL OF OMAHA LIFE INSURANCE COMPANY | $3K | — | $3K | 3.65% |
| INSURANCE OFFICE OF AMERICA3 Filed as: INSURANCE OFFICE OF AMERICA INC | 1855 W STATE ROAD #434 LONGWOOD, FL 32750 | MUTUAL OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 3.35% |
| NATIONAL BENEFIT PARTNER WEST LLC3 | 99 WOOD AVE S STE 501 ISELIN, NJ 08830 | MUTUAL OF OMAHA LIFE INSURANCE COMPANY | $0 | $1K | $1K | 2.00% |
| ACRISURE LLC3 Filed as: ORION RISK MGMT INS SERVICES | 1800 QUAIL STREET SUITE 110 NEWPORT BEACH, CA 92660 | HAWAII DENTAL SERVICE | $938 | — | $938 | 1.29% |
| PSG WASHINGTON INC3 | 2828 COLBY AVENUE SUITE 404 EVERETT, WA 98201 | HAWAII DENTAL SERVICE | $884 | — | $884 | 1.21% |
| PSG WASHINGTON INC3 | PO BOX 387 EVERETT, WA 98206 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 15.00% |
| PSG WASHINGTON INC3 | PO BOX 387 EVERETT, TX 98206 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | — | $1K | 15.00% |
| PSG WASHINGTON INC3 | PO BOX 387 EVERETT, WA 98206 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $772 | — | $772 | 15.00% |
| PSG WASHINGTON INC3 | PO BOX 387 EVERETT, WA 98206 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $691 | — | $691 | 15.00% |
| PSG WASHINGTON INC3 | PO BOX 387 EVERETT, WA 98206 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $228 | — | $228 | 4.99% |
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 | 1,019 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 27 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,046 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 245 | $3.1M |
| Dental | HAWAII DENTAL SERVICE | 114 | $73K |
| Vision | VISION SERVICE PLAN | 901 | $92K |
| Life insurance(3 contracts, 2 carriers) | MUTUAL OF OMAHA LIFE INSURANCE COMPANY | 489 | $186K |
| Short-term disability(2 contracts, 2 carriers) | MUTUAL OF OMAHA LIFE INSURANCE COMPANY | 303 | $91K |
| Long-term disability(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 14 | $10K |
| Other(4 contracts, 2 carriers) | MUTUAL OF OMAHA LIFE INSURANCE COMPANY | 489 | $339K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 901 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.