| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CU BENEFITS ALLIANCE3 | PO BOX 12398 SALEM, OR 97309 | HM LIFE INSURANCE COMPANY | $40K | — | $40K | 10.00% |
| CU BENEFITS ALLIANCE3 | 451 DIVISION ST NE SALEM, OR 97301 | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON | $4K | — | $4K | 3.28% |
| JUDY INEZ BUCHOLTZ3 Filed as: JUDY I BUCHOLTZ | 12517-217TH AVE CT E BONNEY LAKE, WA 98391 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3K | $796 | $4K | 7.38% |
| EBENFITS INSURANCE GROUP LLC3 | PO BOX 359 BLACK DIAMOND, WA 98010 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | — | $2K | 4.47% |
| DONALD C SAVOY INC3 Filed as: DONALD TERRY GOTHAM | 3129 ECLIPSE DRIVE GREEN BAY, WI 54311 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | — | $1K | 2.59% |
| MARK CHARLES MORGAN3 | 2590 WILLAMETTE DRIVE NE LACEY, WA 98516 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $131 | $281 | $412 | 0.85% |
| HR BENEFITS SERVICES, INC. Filed as: NW BENEFITS GROUP LLC | 3104 MCALLISTER ST DUPONT, WA 98327 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $170 | — | $170 | 0.35% |
| TAI D SHIN3 | 2950 POPPY LANE SW TUMWATER, WA 98512 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $16 | $33 | $49 | 0.10% |
| ALBERS & COMPANY3 Filed as: ALBERS & COMPANY INC | 4733 TACOMA MALL BLVD SUITE 200 TACOMA, WA 98409 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $2K | $3K | 8.45% |
| GCG FINANCIAL LLC3 Filed as: WILSON ALBERS ALERA GROUP | 3000 A ST SUITE 400 ANCHORAGE, AK 99503 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | — | $3K | 8.13% |
| ALBERS & COMPANY3 Filed as: ALBERS & COMPANY INC | 4733 TACOMA MALL BLVD SUITE 200 TACOMA, WA 98409 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $2K | $3K | 8.28% |
| GCG FINANCIAL LLC3 Filed as: WILSON ALBERS ALERA GROUP | 3000 A ST SUITE 400 ANCHORAGE, AK 99503 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | — | $3K | 8.18% |
| GCG FINANCIAL LLC3 Filed as: WILSON ALBERS ALERA GROUP | 3000 A ST SUITE 400 ANCHORAGE, AK 99503 | VISION SERVICE PLAN | $2K | — | $2K | 4.24% |
| ALBERS & COMPANY3 Filed as: ALBERS & COMPANY INC | 4733 TACOMA MALL BLVD SUITE 200 TACOMA, WA 98409 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $2K | $3K | 8.47% |
| GCG FINANCIAL LLC3 Filed as: WILSON ALBERS ALERA GROUP | 3000 A STREET SUITE 400 ANCHORAGE, AK 99503 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | — | $3K | 8.13% |
| ALBERS & COMPANY3 | 3000 A ST STE 400 ANCHORAGE, AK 99503 | FIRST CHOICE NETWORK | $950 | — | $950 | 6.35% |
| GCG FINANCIAL LLC3 Filed as: WILSON ALBERS ALERA GROUP | PO BOX 11207 TACOMA, WA 98411 | ZURICH AMERICAN INSURANCE COMPANY | $438 | — | $438 | 15.01% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HM INSURANCE EIN 06-1041332 INSURANCE | Insurance services Service code 23 | — | $362K |
| HEALTHCARE MANAGEMENT ADMINISTRATOR EIN 91-1333840 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | — | $134K |
| CU BENEFITS ALLIANCE EIN 61-1691027 BROKER | Insurance agents and brokers Service code 22 | — | $75K |
| AIG LIFE INSURANCE CO EIN 13-5459480 INSURANCE | Insurance services Service code 23 | — | $34K |
| DELTA DENTAL OF WASHINGTON EIN 91-0621480 CONTRACT ADMINISTRATOR | Claims processing; Contract Administrator Service code 12 | — | $30K |
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 | 407 | 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) | 407 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON | 14 | $130K |
| Vision | VISION SERVICE PLAN | 380 | $37K |
| Life insurance(3 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 383 | $127K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 339 | $34K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON | 14 | $130K |
| Stop-loss / reinsurancereinsurance | HM LIFE INSURANCE COMPANY | 354 | $396K |
| Other(5 contracts, 4 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 414 | $145K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 414 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.