| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| UNKNOWN3 | UNKNOWN BREMERTON, WA 98337 | PREMERA | $43K | $0 | $43K | 3.00% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN AND BROWN OF WASHINGTON, INC. | UNKNOWN BREMERTON, WA 98337 | DELTA DENTAL OF WASHINGTON | $5K | $0 | $5K | 4.45% |
| UNKNOWN3 | UNKNOWN BREMERTON, WA 98337 | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON | $2K | $0 | $2K | 3.00% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN AND BROWN OF TEXAS, INC. | 6300 BRIDGPOINT PARKWAY BUILDING 3 SUITE 500 AUSTIN, TX 78730 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $3K | $0 | $3K | 8.13% |
| BROWN AND BROWN OF FLORIDA, INC.3 | PO BOX 2456 CLEARWATER, FL 33757 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $2K | $0 | $2K | 5.23% |
| IMG5 | 2960 NORTH MERIDIAN STREET INDIANAPOLIS, IN 46208 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $0 | $29 | $29 | 0.07% |
| UNKNOWN3 | UNKNOWN BREMERTON, WA 98337 | STANDARD INSURANCE COMPANY | $309 | $0 | $309 | 2.81% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN AND BROWN OF CALIFORNIA, INC. | PO BOX 743048 LOS ANGELES, CA 90074 | VISION SERVICE PLAN | $950 | $0 | $950 | 10.24% |
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 | 129 | 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) | 129 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | PREMERA | 112 | $1.5M |
| Dental | DELTA DENTAL OF WASHINGTON | 160 | $106K |
| Vision | VISION SERVICE PLAN | 116 | $9K |
| Life insurance(2 contracts, 2 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 124 | $50K |
| Short-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 124 | $39K |
| Long-term disability(2 contracts, 2 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 124 | $50K |
| Prescription drug(2 contracts, 2 carriers) | PREMERA | 112 | $1.5M |
| Other(3 contracts, 3 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 125 | $51K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 160 | — |
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.