| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD, 5TH FLOOR ROLLING MEADOWS, IL 60008 | SYMETRA LIFE INSURANCE COMPANY | $21K | $5K | $26K | 18.85% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 777 108TH AVENUE NE, SUITE 200 BELLEVUE, WA 98004 | WILLAMETTE DENTAL OF WASHINGTON, INC. | $9K | $0 | $9K | 10.89% |
| JUDY INEZ BUCHOLTZ3 Filed as: JUDY INEZ BUCHOLTS | 12517 217TH AVENUE COURT EAST BONNEY LAKE, WA 98391 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $172 | $0 | $172 | 2.26% |
| PAMELA WHITFIELD3 | 646 A AKOAKOA STREET KAILUA, HI 96734 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $60 | $0 | $60 | 0.79% |
| ROXANA BUSCHMAN3 | 400 NE 149TH STREET VANCOUVER, WA 98685 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $13 | $0 | $13 | 0.17% |
| KAREN CLAY KUNKLER3 | 415 SE 177TH AVENUE, UNIT 236 VANCOUVER, WA 98683 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $12 | $0 | $12 | 0.16% |
| HEARTSEASE LLC3 Filed as: HEARTSEASE, LLC AND OTHER AGENTS | 1521 NE 63RD AVENUE HILLSBORO, OR 97124 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $7 | $0 | $7 | 0.09% |
| DONALD C SAVOY INC3 Filed as: DONALD TERRY GOTHAM | 3129 ECLIPSE DRIVE GREEN BAY, WI 54311 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $5 | $0 | $5 | 0.07% |
| BENEFITS BY DESIGN INC3 Filed as: BENEFITS BY DESIGN, INC. | 2101 NE 279TH STREET RIDGEFIELD, WA 98642 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $5 | $0 | $5 | 0.07% |
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 | 113 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 113 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | WILLAMETTE DENTAL OF WASHINGTON, INC. | 146 | $80K |
| Life insurance(2 contracts, 2 carriers) | SYMETRA LIFE INSURANCE COMPANY | 113 | $146K |
| Long-term disability | SYMETRA LIFE INSURANCE COMPANY | 113 | $139K |
| Other | SYMETRA LIFE INSURANCE COMPANY | 113 | $139K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 146 | — |
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.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.