| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MCM3 Filed as: MCM FINANCIAL | 1325 4TH AVE., STE. 2100 SEATTLE, WA 98101 | AETNA LIFE INSURANCE COMPANY | $82K | $4K | $86K | 3.30% |
| ASSUREDPARTNERS3 Filed as: ASSURED PARTNERS OF WASHINGTON | 1325 4TH AVE., STE. 2100 SEATTLE, WA 98101 | DELTA DENTAL OF WASHINGTON | $9K | — | $9K | 5.00% |
| MCM3 | 1325 4TH AVE., STE. 2100 SEATTLE, WA 98101 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4K | $1K | $5K | 8.28% |
| MCM3 | 1325 4TH AVE., STE. 2100 SEATTLE, WA 98101 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | $956 | $4K | 13.71% |
| ASSUREDPARTNERS3 Filed as: ASSUREDPARTNERS OF WASHINGTON | 1325 4TH AVE., STE. 2100 SEATTLE, WA 98101 | VISION SERVICE PLAN | $973 | — | $973 | 5.99% |
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 | 164 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 165 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | AETNA LIFE INSURANCE COMPANY | 999 | $2.8M |
| Dental | DELTA DENTAL OF WASHINGTON | 164 | $175K |
| Vision | VISION SERVICE PLAN | 152 | $16K |
| Life insurance(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 84 | $88K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 67 | $29K |
| Long-term disability(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 84 | $88K |
| Prescription drug(2 contracts, 2 carriers) | AETNA LIFE INSURANCE COMPANY | 999 | $2.8M |
| Other(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 84 | $88K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 999 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.