| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CROWN RISK MANAGEMENT, LLC3 Filed as: MANNA INSRUANCE GROUP LLC | 1706 FRONT ST PMB 794 LYNDEN, WA 98264 | REGENCE BLUESHIELD | $52K | $5K | $57K | 5.00% |
| STEPHANIE SHEPPA3 Filed as: STEPHANIE JO HANSEN | 20144 GINA MARIE LANE BURLINGTON, WA 98233 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3K | $9K | $12K | 8.64% |
| MANNA INSURANCE GROUP LLC3 | 1706 FRONT ST PMB 794 LYNDEN, WA 98264 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $7K | $3K | $10K | 7.10% |
| DANIEL SHARP3 | 1911 98TH ST SE EVERETT, WA 98208 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $5K | $7K | 5.12% |
| MARY DAUGHERTY3 | 7625 STAR GAZING LANDE KNOXVILLE, TN 37938 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $5K | $2K | $6K | 4.71% |
| RICH IN BENEFITS INC3 | 13109 NE 123RD ST KIRKLAND, WA 98034 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4K | $2K | $6K | 4.21% |
| MEGAN ELIZABETH CASTO3 | HOME OFFICE COLUMBIA, SC 29202 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3K | $2K | $5K | 3.52% |
| JM TAMER & CO3 | 6500 PAPERMILL DR STE 201 KNOXVILLE, TN 37922 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $722 | $416 | $1K | 0.83% |
| ALLISON RENEE MOSER3 | 2211 HENRY STREET BELLINGHAM, WA 98225 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $920 | — | $920 | 0.67% |
| JULIA MICHELLE TAMER3 | 6500 PAPERMILL DR STE 201 KNOXVILLE, TN 37922 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $234 | $6 | $240 | 0.18% |
| ELTHON ISRAEL CRUZ3 | 893 SOUTH 2100 WEST OREN, UT 84059 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $147 | — | $147 | 0.11% |
| DANIEL E WILLIAMS3 Filed as: DANIEL LEE ISON | 5677 W 10770 N HIGHLAND, UT 84003 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $10 | — | $10 | 0.01% |
| RICHARD D SCHOOLEY3 | 563 BALLAS PARK DRIVE ST LOUIS, MO 63122 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $9 | $1 | $10 | 0.01% |
| JOEL N NEWMAN AGENCY LLC3 | 924-B NW 52ND ST SEATTLE, WA 98107 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | $0 | $1 | 0.00% |
| WA EMPLOYEE BENEFITS LLC3 | 24519 36TH AVE S KENT, WA 98032 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $0 | $1 | $1 | 0.00% |
| ELIZABETH BETTRIDGE3 | 21231 14TH AVE. S. DES MOINES, WA 98198 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $0 | $1 | $1 | 0.00% |
| LAURABETH CHRISTENSEN3 Filed as: LAURABETH CHRISTIANSEN | 16915 SE 272ND ST COVINGTON, WA 98042 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | $0 | $1 | 0.00% |
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 | 122 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 125 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | REGENCE BLUESHIELD | 177 | $1.2M |
| Dental | REGENCE BLUESHIELD | 177 | $1.2M |
| Vision | REGENCE BLUESHIELD | 177 | $1.2M |
| Life insurance | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 156 | $137K |
| Other | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 156 | $137K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 177 | — |
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.