| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ASSUREDPARTNERS3 | 1325 4TH AVE., STE. 2100 SEATTLE, WA 98101 | KAISER PERMANENTE | $28K | — | $28K | 4.31% |
| ASSUREDPARTNERS3 | 1325 4TH AVE., STE. 2100 SEATTLE, WA 98101 | KAISER PERMANENTE | $17K | — | $17K | 4.37% |
| SEATTLE REGIONAL OFFICE3 | PLAZA AT YARROW BAY 10230 NE POINTS SUITE 550 KIRKLAND, WA 980337808 | MUTUAL OF AMERICA LIFE INSURANCE COMPANY | — | $315 | $315 | 0.59% |
| ASSUREDPARTNERS3 | 1325 4TH AVE., STE. 2100 SEATTLE, WA 98101 | VISION SERVICE PLAN | $745 | — | $745 | 5.91% |
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 | 103 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 17 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 123 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts) | KAISER PERMANENTE | 53 | $1.0M |
| Dental | DELTA DENTAL OF WASHINGTON | 96 | $83K |
| Vision | VISION SERVICE PLAN | 101 | $13K |
| Life insurance | MUTUAL OF AMERICA LIFE INSURANCE COMPANY | 120 | $53K |
| Prescription drug(2 contracts) | KAISER PERMANENTE | 53 | $1.0M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 120 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.