| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GHB INC3 Filed as: GHB INSURANCE | PO BOX 1608 OLYMPIA, WA 98507 | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON OPTIONS, INC. | $17K | — | $17K | 3.90% |
| GHB INC3 Filed as: GHB INSURANCE | PO BOX 1608 OLYMPIA, WA 98507 | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON OPTIONS, INC. | $15K | — | $15K | 3.93% |
| BELL-ANDERSON AGENCY INC3 | DBA GHB INSURANCE 556 LILLY RD SE, STE A OLYMPIA, WA 98501 | PRINCIPAL LIFE INSURANCE COMPANY | $13K | $3K | $16K | 8.96% |
| GA SOLUTIONS LLC3 | 311 CLOCK TOWER CMNS BREWSTER, NY 10509 | PRINCIPAL LIFE INSURANCE COMPANY | $8K | — | $8K | 4.43% |
| ACRISURE LLC3 | PO BOX 2897 EVANS, GA 30809 | PRINCIPAL LIFE INSURANCE COMPANY | — | $2K | $2K | 0.99% |
| GHB INC3 Filed as: GHB INSURANCE | PO BOX 1608 OLYMPIA, WA 98507 | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON | $7K | — | $7K | 3.90% |
| BELL-ANDERSON AGENCY INC3 Filed as: BELL-ANDERSON AGENCY | 600 SW 39TH ST STE 200 RENTON, WA 98057 | VISION SERVICE PLAN | $864 | — | $864 | 6.51% |
| GROUP BENEFITS LTD3 Filed as: GROUP BENEFITS, LTD. | 12006 RIDGEMONT DR URBANDALE, IA 50323 | VISION SERVICE PLAN | $530 | — | $530 | 3.99% |
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 | 112 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 112 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON OPTIONS, INC. | 67 | $980K |
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 212 | $176K |
| Vision | VISION SERVICE PLAN | 111 | $13K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 212 | $176K |
| Short-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 212 | $176K |
| Long-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 212 | $176K |
| Other | PRINCIPAL LIFE INSURANCE COMPANY | 212 | $176K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 212 | — |
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.