| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | 1015 A STREET, SUITE 800 TACOMA, WA 98402 | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON OPTIONS, INC. | $17K | $0 | $17K | 3.77% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 603 NORTH 39TH AVENUE, SUITE 102 YAKIMA, WA 98902 | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON OPTIONS, INC. | $17K | $0 | $17K | 3.77% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 1015 A STREET, SUITE 800 TACOMA, WA 98402 | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON | $5K | $0 | $5K | 3.85% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 603 NORTH 39TH AVENUE, SUITE 102 YAKIMA, WA 98902 | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON | $5K | $0 | $5K | 3.85% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 777 108TH AVENUE NE, SUITE 200 BELLEVUE, WA 98004 | METROPOLITAN LIFE INSURANCE COMPANY | $2K | $41 | $2K | 4.63% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | METROPOLITAN LIFE INSURANCE COMPANY | — | $699 | $699 | 1.44% |
| LIAZON BENEFITS INC5 Filed as: LIAZON BENEFITS INC. | 199 SCOTT STREET, 8TH FLOOR BUFFALO, NY 14204 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $566 | $566 | 1.17% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 1111 SUPERIOR AVENUE EAST SUITE 1601 CLEVELAND, OH 44114 | METROPOLITAN LIFE INSURANCE COMPANY | — | $6 | $6 | 0.01% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 777 108TH AVENUE NE, SUITE 200 BELLEVUE, WA 98004 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $6K | $0 | $6K | 12.62% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $4K | $4K | 8.29% |
| LIAZON BENEFITS INC5 Filed as: LIAZON CORPORATION | 199 SCOTT STREET, 8TH FLOOR BUFFALO, NY 14204 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $135 | $135 | 0.29% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN AND BROWN OF WASHINGTON, INC. | UNKNOWN TACOMA, WA 98409 | WILLAMETTE DENTAL OF WASHINGTON, INC. | $388 | $0 | $388 | 5.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 777 108TH AVENUE NE BELLEVUE, WA 98004 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | $963 | $0 | $963 | 12.55% |
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 | 81 | 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) | 81 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON OPTIONS, INC. | 59 | $603K |
| Dental(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 86 | $56K |
| Vision | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | 81 | $8K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 81 | $46K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 81 | $46K |
| Prescription drug(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON OPTIONS, INC. | 59 | $603K |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 81 | $46K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 86 | — |
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 compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.