| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| COLLEEN MARIE STEVENS3 Filed as: COLLEEN M. STEVENS | 528 EAST SPOKANE FALLS BOULEVARD SUITE 305 SPOKANE, WA 99202 | ASURIS NORTHWEST HEALTH | $36K | $4K | $40K | 5.09% |
| COLLEEN MARIE STEVENS3 Filed as: COLLEEN M. STEVENS | 528 EAST SPOKANE FALLS BOULEVARD SUITE 3 SPOKANE, WA 99202 | PRINCIPAL LIFE INSURANCE COMPANY | $5K | $0 | $5K | 7.36% |
| TERRY K ALLEN3 Filed as: TERRY K. ALLEN | 20930 EAST HAPPY TRAILS LANE OTIS ORCHARDS, WA 99027 | AFLAC | $4K | $72 | $4K | 11.94% |
| JESSICA SULLIVAN & OTHER AGENTS3 | 16 SOUTH BIRCH STREET OMAK, WA 98841 | AFLAC | $695 | $26 | $721 | 2.36% |
| KEVIN C HALLAM3 Filed as: KEVIN C. HALLAM | 2145 HYACINTH DRIVE BILLINGS, MT 59105 | AFLAC | $407 | $0 | $407 | 1.33% |
| STEVEN PEDERSEN3 | 1405 EAST CACTUS AVENUE POST FALLS, ID 83854 | AFLAC | $262 | $0 | $262 | 0.86% |
| JIMMIE J DELBRIDGE3 Filed as: JIMMIE J. DELBRIDGE | 1924 EAST FOXBOROUGH COURT HAYDEN, ID 83835 | AFLAC | $138 | $16 | $154 | 0.50% |
| EDWIN J TEDERS3 Filed as: EDWIN J. TEDERS | 1345 183RD AVENUE NE BELLEVUE, WA 98008 | AFLAC | $112 | $0 | $112 | 0.37% |
| VON KLOHE3 | 1020 EAST 54TH AVENUE SPOKANE, WA 99223 | AFLAC | $102 | $0 | $102 | 0.33% |
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 | 124 | 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) | 124 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | ASURIS NORTHWEST HEALTH | 87 | $779K |
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 143 | $71K |
| Vision | PRINCIPAL LIFE INSURANCE COMPANY | 143 | $71K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 143 | $71K |
| Short-term disability | AFLAC | 27 | $31K |
| Prescription drug | ASURIS NORTHWEST HEALTH | 87 | $779K |
| Other(3 contracts, 3 carriers) | ASURIS NORTHWEST HEALTH | 143 | $880K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 143 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.