| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ARMFIELD HARRISON & THOMAS3 | 20 S KING STREET SEATTLE, WA 98101 | PACIFICSOURCE HEALTH PLANS | $18K | $1K | $20K | 3.21% |
| ARMFIELD HARRISON & THOMAS3 | 6857 40TH AVE NE SEATTLE, WA 98115 | WILLAMETTE DENTAL OF IDAHO, INC. | $965 | — | $965 | 5.00% |
| ARMFIELD HARRISON & THOMAS3 | 600 UNIVERSITY ST STE 1200 SEATTLE, WA 98101 | UNITED HERITAGE LIFE INS. CO. | $1K | — | $1K | 11.27% |
| ARMFIELD HARRISON & THOMAS3 | 600 UNIVERSITY ST STE 1200 SEATTLE, WA 98101 | UNITED HERITAGE LIFE INS. CO. | $657 | — | $657 | 10.00% |
| ARMFIELD HARRISON & THOMAS3 | 600 UNIVERSITY ST STE 1200 SEATTLE, WA 98101 | UNITED HERITAGE LIFE INS. CO. | $898 | — | $898 | 15.00% |
| ARMFIELD HARRISON & THOMAS3 | 600 UNIVERSITY ST STE 1200 SEATTLE, WA 98101 | UNITED HERITAGE LIFE INS. CO. | $421 | — | $421 | 8.39% |
| ARMFIELD HARRISON & THOMAS3 | 600 UNIVERSITY ST STE 1200 SEATTLE, WA 98101 | UNITED HERITAGE LIFE INS. CO. | $478 | — | $478 | 14.99% |
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 | 121 | 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) | 121 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | PACIFICSOURCE HEALTH PLANS | 167 | $608K |
| Dental | WILLAMETTE DENTAL OF IDAHO, INC. | 50 | $19K |
| Vision | UNITED HERITAGE LIFE INS. CO. | 90 | $7K |
| Life insurance(2 contracts) | UNITED HERITAGE LIFE INS. CO. | 121 | $8K |
| Short-term disability | UNITED HERITAGE LIFE INS. CO. | 121 | $12K |
| Long-term disability | UNITED HERITAGE LIFE INS. CO. | 48 | $6K |
| Prescription drug | PACIFICSOURCE HEALTH PLANS | 167 | $608K |
| Other | UNITED HERITAGE LIFE INS. CO. | 37 | $3K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 167 | — |
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."
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.