| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MANNA INSURANCE GROUP LLC3 | 1706 FRONT ST PMB 794 LYNDEN, WA 98264 | REGENCE BLUESHIELD | $61K | $5K | $66K | 5.24% |
| MANNA INSURANCE GROUP LLC3 | 1706 FRONT ST PMB 794 LYNDEN, WA 98264 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $6K | — | $6K | 5.26% |
| RICH IN BENEFITS INC3 | 13109 NE 123RD ST APT P240 KIRKLAND, WA 98034 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $572 | $3K | 2.42% |
| MEGAN ELIZABETH CASTO3 | 10340 CARNEY DR SE OLYMPIA, WA 98501 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $624 | $3K | 2.33% |
| MARY DAUGHERTY3 | PO BOX 119 ROCKY TOP, TN 37769 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $542 | $2K | 2.22% |
| STEPHANIE SHEPPA3 Filed as: STEPHANIE JO HANSEN | 20144 GINA MARIE LANE BURLINGTON, WA 98233 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $64 | $2K | 1.53% |
| DANIEL SHARP3 | 11622 50TH DR SE EVERETT, WA 98208 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $382 | — | $382 | 0.35% |
| SCOTT FENTON3 Filed as: SCOTT RONALD FENTON | 10506 RUSTIC RD SOUTH SEATTLE, WA 98178 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $174 | $143 | $317 | 0.29% |
| KALEB JORDAN FIELDS3 | 2301 W WHITE AVE APT 828 MCKINNEY, TX 75071 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $98 | — | $98 | 0.09% |
| ZACHAREE KEITH SIAHPUSH3 | 6727 MLK JR WAY S STE M SEATTLE, WA 98118 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $80 | $8 | $88 | 0.08% |
| JULIA MICHELLE TAMER3 | 6500 PAPERMILL DR STE 201 KNOXVILLE, TN 37919 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $76 | — | $76 | 0.07% |
| BENEFOUNDRY INC3 | 3013 LARGE HOP LN ANTIOCH, TN 37013 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $30 | $28 | $58 | 0.05% |
| ALCYON MOSCHOGIANIS3 | 2904 139TH PL SE MILL CREEK, WA 98012 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $42 | — | $42 | 0.04% |
| ELTHON ISRAEL CRUZ3 | 893 SOUTH 2100 W OREM, UT 84059 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $31 | — | $31 | 0.03% |
| MARIA VERONICA JARQUE3 | 4744 N PAULINA ST APT 1E CHICAGO, IL 60640 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $11 | $2 | $13 | 0.01% |
| KEITH LEPACK3 Filed as: KEITH HOWARD LEFEVRE | 8885 LADY MADONNA CIR UNIT 306 HIGHLANDS RANCH, CO 80129 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $7 | $2 | $9 | 0.01% |
| KENNIE SMITH3 | PO BOX 507 CHENEYVILLE, LA 71325 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3 | — | $3 | 0.00% |
| WENDY DAWN PACK3 | 16109 WATT WAY RAMONA, CA 92065 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | — | $2 | 0.00% |
| CROWN RISK MANAGEMENT, LLC3 Filed as: MANNA INSRUANCE GROUP, LLC | 719 GROVER ST LYNDEN, WA 98264 | CONTINENTAL AMERICAN INSURANCE COMPANY | $10K | — | $10K | 19.85% |
| MANNA INSURANCE GROUP LLC3 | 1706 FRONT ST PMB STE 794 LYNDEN, WA 98264 | UNUM INSURANCE COMPANY | $865 | — | $865 | 10.00% |
| MANNA INSURANCE GROUP LLC3 | 1706 FRONT STREET PMB STE 794 LYNDEN, WA 98264 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $412 | — | $412 | 19.41% |
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 | 124 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 124 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | REGENCE BLUESHIELD | 192 | $1.4M |
| Dental | REGENCE BLUESHIELD | 192 | $1.3M |
| Vision | REGENCE BLUESHIELD | 192 | $1.3M |
| Life insurance(2 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 212 | $111K |
| Short-term disability | CONTINENTAL AMERICAN INSURANCE COMPANY | 84 | $49K |
| Other(3 contracts, 3 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 201 | $166K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 212 | — |
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.