| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | 777 108TH AVENUE NE, SUITE 200 BELLEVUE, WA 98004 | REGENCE BLUESHIELD | $0 | $167 | $167 | 0.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 777 108TH AVENUE NE, SUITE 200 BELLEVUE, WA 98004 | LIFEMAP ASSURANCE COMPANY | $31K | $0 | $31K | 16.13% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 777 108TH AVENUE NE, SUITE 200 BELLEVUE, WA 98004 | KAISER FOUNDATION HEALTH PLAN OF HAWAII | $3K | $0 | $3K | 3.53% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 777 108TH AVENUE NE, SUITE 200 BELLEVUE, WA 98004 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4K | $0 | $4K | 17.50% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD, 11TH FLOOR ROLLING MEADOWS, IL 60008 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $299 | $299 | 1.25% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 777 108TH AVENUE NE, SUITE 200 BELLEVUE, WA 98004 | STANDARD INSURANCE COMPANY | $3K | $200 | $3K | 26.78% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | STANDARD INSURANCE COMPANY | $0 | $281 | $281 | 2.38% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 603 NORTH 39TH AVENUE, SUITE 102 YAKIMA, WA 98902 | HAWAII DENTAL SERVICE | $219 | $0 | $219 | 2.93% |
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 | 537 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 539 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | REGENCE BLUESHIELD | 421 | $3.8M |
| Dental(2 contracts, 2 carriers) | DELTA DENTAL OF WASHINGTON | 479 | $283K |
| Vision(3 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN OF HAWAII | 382 | $171K |
| Life insurance(2 contracts, 2 carriers) | LIFEMAP ASSURANCE COMPANY | 453 | $216K |
| Short-term disability | LIFEMAP ASSURANCE COMPANY | 453 | $192K |
| Long-term disability | LIFEMAP ASSURANCE COMPANY | 453 | $192K |
| Prescription drug(3 contracts, 3 carriers) | REGENCE BLUESHIELD | 421 | $3.8M |
| Other(3 contracts, 3 carriers) | LIFEMAP ASSURANCE COMPANY | 536 | $231K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 536 | — |
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 comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.