| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ALBERS & COMPANY3 | 4733 TACOMA MALL BLVD SUITE 200 TACOMA, WA 98409 | DELTA DENTAL OF WASHINGTON | $13K | — | $13K | 4.58% |
| ALBERS & COMPANY3 Filed as: ALBERS & COMPANY INC | PO BOX 11207 TACOMA, WA 98411 | AIG BENEFIT SOLUTIONS | $23K | — | $23K | 10.06% |
| CU BENEFITS ALLIANCE3 | 451 DIVISION STREET NE SALEM, OR 97301 | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON | $6K | — | $6K | 3.89% |
| JUDY INEZ BUCHOLTZ3 Filed as: JUDY I BUCHOLTZ | 12517-217TH AVE CT E BONNEY LAKE, WA 98391 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3K | $94 | $3K | 6.45% |
| EBENFITS INSURANCE GROUP LLC3 | PO BOX 359 BLACK DIAMOND, WA 98010 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3K | — | $3K | 5.51% |
| DONALD C SAVOY INC3 Filed as: DONALD TERRY GOTHAM | 3129 ECLIPSE DRIVE GREEN BAY, WI 54311 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | — | $2K | 3.46% |
| BRIAN WHITE3 Filed as: BRIAN RODERICK | 3104 MCALLISTER ST DUPONT, WA 98327 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $389 | $215 | $604 | 1.25% |
| ALBERS & COMPANY3 Filed as: ALBERS & COMPANY INC | 4733 TACOMA MALL BLVD SUITE 200 TACOMA, WA 98409 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $1K | $5K | 14.85% |
| ALBERS & COMPANY3 Filed as: ALBERS & COMPANY INC | 4733 TACOMA MALL BLVD SUITE 200 TACOMA, WA 98409 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $1K | $5K | 15.46% |
| ALBERS & COMPANY3 Filed as: ALBERS & COMPANY INC | 4733 TACOMA MALL BLVD SUITE 200 TACOMA, WA 98409 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $886 | $5K | 14.84% |
| ALBERS & COMPANY3 Filed as: ALBERS & COMPANY INC | 3000 A ST SUITE 400 ANCHORAGE, AK 99503 | VISION SERVICE PLAN | $1K | — | $1K | 4.98% |
| ALBERS & COMPANY3 Filed as: ALBERS & COMPANY INC | PO BOX 11207 TACOMA, WA 98411 | ZURICH AMERICAN INSURANCE COMPANY | $414 | — | $414 | 15.01% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HEALTHCARE MANAGEMENT ADMINISTRATOR EIN 91-1333840 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | — | $116K |
| CU BENEFITS ALLIANCE EIN 61-1691027 BROKER | Insurance agents and brokers Service code 22 | — | $69K |
| FIRST CHOICE HEALTH NETWORK INC EIN 91-1272766 CONTRACT ADMINISTRATOR | Contract Administrator; Claims processing Service code 12 | — | $14K |
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 | 0 | 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) | 0 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON | 295 | $173K |
| Dental | DELTA DENTAL OF WASHINGTON | 532 | $294K |
| Vision | VISION SERVICE PLAN | 341 | $26K |
| Life insurance(3 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 343 | $119K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 300 | $31K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON | 17 | $148K |
| Stop-loss / reinsurancereinsurance | AIG BENEFIT SOLUTIONS | 588 | $231K |
| Other(5 contracts, 4 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 343 | $146K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 588 | — |
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.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.