| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HEALTHCARE MANAGEMENT ADMINISTRATOR5 Filed as: HEALTHCARE MGMT ADMINISTRATORS | 220 120TH AVE. NE BELLEVUE, WA 98005 | SUN LIFE ASSURANCE COMPANY OF CANADA | — | $3K | $3K | 1.22% |
| MCM3 | 1325 4TH AVE., STE. 2100 SEATTLE, WA 98101 | SUN LIFE ASSURANCE COMPANY OF CANADA | $2K | — | $2K | 0.82% |
| UNITED BENEFIT ADVISORS NW LLC5 Filed as: UNITED BENEFIT ADVISORS NORTHWEST | 7632 SW DURHAM RD., STE. 115 TIGARD, OR 97224 | SUN LIFE ASSURANCE COMPANY OF CANADA | $996 | — | $996 | 0.41% |
| ASSUREDPARTNERS3 Filed as: ASSURED PARTNERS OF WASHINGTON LLC | 1325 4TH AVE., STE. 2100 SEATTLE, WA 98101 | SUN LIFE ASSURANCE COMPANY OF CANADA | $2K | — | $2K | 6.98% |
| MCM3 | 1325 4TH AVE., STE. 2100 SEATTLE, WA 98101 | SUN LIFE ASSURANCE COMPANY OF CANADA | $334 | — | $334 | 1.50% |
| M FINANCIAL HOLDINGS INC3 Filed as: M FINANCIAL GROUP | 1125 NW COUCH ST., STE. 900 PORTLAND, OR 97209 | SUN LIFE ASSURANCE COMPANY OF CANADA | — | $188 | $188 | 0.84% |
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 | 120 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 15 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 135 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 107 | $22K |
| Short-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 107 | $22K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 107 | $22K |
| Stop-loss / reinsurancereinsurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 120 | $242K |
| 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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.