| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ADEPT BENEFITS LLC3 | 14205 SE 36TH ST SUITE 100 BELLEVUE, WA 98006 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $7K | — | $7K | 15.00% |
| MEGAN R SILVERMAN3 Filed as: MEGAN RAE SILVERMAN | 1423 MARTIN MEADOWS DRIVE FALLSTON, MD 21047 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4K | $201 | $4K | 11.95% |
| MEGAN R NARRANCE3 | 14205 SE 36TH STREET BELLEVUE, WA 98006 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | — | $2K | 5.12% |
| ELITE-VB LLC3 | 341 W. TUDOR ROAD ANCHORAGE, AK 99503 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $885 | — | $885 | 2.67% |
| ZACHARY EUGENE VICKERS3 | 24 S LOCUST ST MARIETTA, PA 17547 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $346 | $79 | $425 | 1.28% |
| DAVID J MCCLELLAN3 | 118 ROYAL HORSE WAY REINHOLDS, PA 17569 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $116 | $270 | $386 | 1.17% |
| RANDELL LYNN KRUSE3 | 2018 DAYTON COURT SE RENTON, WA 98055 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $158 | — | $158 | 0.48% |
| HOWARD HOROWITZ3 Filed as: HOWARD J HOROWITZ | 2610 ALCOTT STREET CARMEL, IN 46032 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $113 | $41 | $154 | 0.47% |
| JAMES BARTLETT LLC3 | 3138 GREENRIDGE DRIVE LANCASTER, PA 17601 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $113 | $34 | $147 | 0.44% |
| BRIAN T MURPHY LLC3 | 5002 47TH AVE SW SEATTLE, WA 98136 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $146 | — | $146 | 0.44% |
| DANA MARIE MOWATT3 | 23701 S WESTERN AVE #112 TORRANCE, CA 90501 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $110 | — | $110 | 0.33% |
| RICH IN BENEFITS INC3 | 13109 NE 123RD ST KIRKLAND, WA 98034 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $56 | $23 | $79 | 0.24% |
| MEGAN ELIZABETH CASTO3 | 10340 CARNEY DRIVE SE OLYMPIA, WA 98501 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $33 | $9 | $42 | 0.13% |
| BRANDON MARCELLO CENTO3 | 7060 OAKBAY DRIVE NOBLESVILLE, IN 46062 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $10 | $6 | $16 | 0.05% |
| DOUGLAS EDWARD VIESELMEYER3 | 14405 115TH AVE CT E PUYALLUP, WA 98374 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $15 | $1 | $16 | 0.05% |
| LUIS EDUARDO CARDENAS3 | 26341 SE DUTHIE HILL ROAD ISSAQUAH, WA 98029 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $14 | — | $14 | 0.04% |
| KAREN MARIE FLANAGAN3 | PO BOX 871614 WASILLA, AK 99687 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $8 | — | $8 | 0.02% |
| DEANA SCHROEDER3 | 23115 120 AVE SE KENT, WA 98031 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $7 | — | $7 | 0.02% |
| G SCOTT COOKE3 Filed as: SCOTT PETERSON | 21926 43RD DRIVE SE BOTHELL, WA 98021 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | $1 | $3 | 0.01% |
| LISA LOUISE ROBBERSON3 | 13120 102ND LANE NE #3 KIRKLAND, WA 98034 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | — | $2 | 0.01% |
| MARK CHARLES MORGAN3 | 1880 SOUTH DAIRY ASHFORD HOUSTON, TX 77077 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | — | $1 | $1 | 0.00% |
| TAI D SHIN3 | 1301 PINE LEAF DR LAS VEGAS, NV 89144 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | — | $1 | $1 | 0.00% |
| MEGAN R SILVERMAN3 Filed as: MEGAN RAE SILVERMAN | 1423 MARTIN MEADOWS DRIVE FALLSTON, MD 21047 | THE PAUL REVERE LIFE INSURANCE COMPANY | $805 | — | $805 | 42.55% |
| MEGAN R NARRANCE3 | 14205 SE 36TH STREET BELLEVUE, WA 98006 | THE PAUL REVERE LIFE INSURANCE COMPANY | $393 | — | $393 | 20.77% |
| ZACKARY EUGENE VICKERS3 | 24 S LOCUST ST MARIETTA, PA 17547 | THE PAUL REVERE LIFE INSURANCE COMPANY | $80 | — | $80 | 4.23% |
| DAVID J MCCLELLAN3 Filed as: DAVID J. MCCLELLAN | 118 ROYAL HORSE WAY REINHOLDS, PA 17569 | THE PAUL REVERE LIFE INSURANCE COMPANY | $25 | $13 | $38 | 2.01% |
| JAMES BARTLETT LLC3 | 3138 GREENRIDGE DRIVE LANCASTER, PA 17601 | THE PAUL REVERE LIFE INSURANCE COMPANY | $25 | — | $25 | 1.32% |
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 | 273 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 277 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 52 | $704K |
| Dental(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN OF HAWAII | 295 | $341K |
| Vision(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN OF HAWAII | 207 | $231K |
| Life insurance(3 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 268 | $88K |
| Prescription drug(4 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 52 | $704K |
| Other(4 contracts, 3 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 268 | $90K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 295 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.