| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MOLONEY & ONEILL LIFE INC3 Filed as: MOLONEY & ONEILL LIFE, INC. | 818 W RIVERSIDE SUITE 800 SPOKANE, WA 99201 | LIFEWISE ASSURANCE COMPANY | $19K | — | $19K | 4.85% |
| MOLONEY & ONEILL LIFE INC3 Filed as: MOLONEY & ONEILL LIFE, INC. | 818 W RIVERSIDE SUITE 800 SPOKANE, WA 99201 | VISION SERVICE PLAN | $2K | — | $2K | 1.34% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 2850 GOLF ROAD, STE 1000 ROLLING MEADOWS, IL 60008 | VISION SERVICE PLAN | $1K | — | $1K | 1.12% |
| MOLONEY & ONEILL LIFE INC3 Filed as: MOLONEY & ONEILL LIFE, INC. | 818 W RIVERSIDE SUITE 800 SPOKANE, WA 99201 | WILLAMETTE DENTAL OF WASHINGTON, INC. | — | $6K | $6K | 12.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| PREMERA BLUE CROSS EIN 91-0499247 CONTRACT ADMINISTRATION | Contract Administrator Service code 13 | — | $437K |
| WASHINGTON DENTAL SERVICE EIN 91-0621480 CONTRACT ADMINISTRATION | Accounting (including auditing) Service code 10 | — | $79K |
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 | 812 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 10 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 822 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | WILLAMETTE DENTAL OF WASHINGTON, INC. | 109 | $52K |
| Vision | VISION SERVICE PLAN | 780 | $113K |
| Other | LIFEWISE ASSURANCE COMPANY | 799 | $391K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 799 | — |
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.