| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 Filed as: ACRISURE NW PARTNERS INSURANCE | 19401 40TH AVE W, STE. 440 LYNNWOOD, WA 98036 | DELTA DENTAL OF WASHINGTON | $34K | $0 | $34K | 2.21% |
| BELL-ANDERSON AGENCY INC3 Filed as: BELL ANDERSON AGENCY INC. - BW | 600 SW 39TH, SUITE 200 RENTON, WA 98057 | DELTA DENTAL OF WASHINGTON | $12K | $0 | $12K | 0.79% |
| ACRISURE LLC3 Filed as: ACRISURE NW PARTNERS INSURANCE SVCS | 19401 40TH AVE W STE 440 LYNNWOOD, WA 98036 | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON | $14K | $0 | $14K | 2.02% |
| BELL-ANDERSON AGENCY INC Filed as: BELL ANDERSON AGENCY INC | 600 SW 39TH ST, SUITE 200 RENTON, WA 980584919 | KAISER FOUNDATION HEALTH PLAN, INC | $6K | $0 | $6K | 1.31% |
| ACRISURE LLC | PO BOX 3725 COEUR D ALENE, ID 838162529 | KAISER FOUNDATION HEALTH PLAN, INC | $6K | $0 | $6K | 1.26% |
| BELL-ANDERSON AGENCY INC Filed as: BELL ANDERSON AGENCY INC | 600 SW 39TH, SUITE 200 RENTON, WA 98058 | KAISER FOUNDATION HEALTH PLAN, INC | $5K | $0 | $5K | 1.33% |
| ACRISURE LLC Filed as: ACRISURE NW PARTNERS INSURANCE SVCS | 100 OTTAWA AVE SW GRAND RAPIDS, MI 495035087 | KAISER FOUNDATION HEALTH PLAN, INC | $5K | $0 | $5K | 1.22% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| QBE NORTH AMERICA EIN 27-0918826 NONE | Insurance services Service code 23 | 55 WATER ST NEW YORK, NY 10041 | $1.7M |
| HEALTHCARE MANAGEMENT ADMINSTRATORS EIN 91-1333540 NONE | Contract Administrator Service code 13 | 10700 NORTHUP WAY #110 BELLEVUE, WA 98004 | $602K |
| BELL ANDERSON AGENCY EIN 91-0756278 NONE | Insurance agents and brokers Service code 22 | 600 SW 39TH ST, SUITE 200 RENTON, WA 98057 | $20K |
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 | 2,042 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 37 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 2,079 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF WASHINGTON | 3,022 | $1.5M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 3,022 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.