| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ALLIANT INSURANCE SERVICES, INC.3 | 818 W RIVERSIDE AVE, STE 800 SPOKANE, WA 99201 | PREMERA BLUE CROSS | $20K | $11K | $30K | 2.12% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 906 W 2ND AVE, STE 400 SPOKANE, WA 99201 | PREMERA BLUE CROSS | $20K | $4K | $24K | 1.64% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES INC | 818 W RIVERSIDE AVE, STE 800 SPOKANE, WA 99201 | SUN LIFE ASSURANCE COMPANY OF CANADA | $2K | $0 | $2K | 5.07% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 2850 GOLF RD, 5TH FLOOR ROLLING MEADOWS, IL 60008 | SUN LIFE ASSURANCE COMPANY OF CANADA | $2K | $0 | $2K | 4.93% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES INC | 1420 5TH AVE, #1500 SEATTLE, WA 98101 | SUN LIFE ASSURANCE COMPANY OF CANADA | $0 | $560 | $560 | 1.62% |
| TERRY K ALLEN3 | 20930 E HAPPY TRAILS LANE OTIS ORCHARDS, WA 99027 | CONTINENTAL AMERICAN INSURANCE COMPANY | $865 | $0 | $865 | 3.43% |
| ALLIANT INSURANCE SERVICES, INC.3 | 701 B STREET, 6TH FLOOR SAN DIEGO, CA 92101 | CONTINENTAL AMERICAN INSURANCE COMPANY | $782 | $0 | $782 | 3.10% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 111 VETERANS BLVD, STE 1130 METAIRIE, LA 70005 | CONTINENTAL AMERICAN INSURANCE COMPANY | $433 | $0 | $433 | 1.72% |
| KYONG H. GOINS3 Filed as: KYONG HIU GOINS | 7711 27TH AVE SW SEATTLE, WA 98126 | CONTINENTAL AMERICAN INSURANCE COMPANY | $247 | $0 | $247 | 0.98% |
| JIMMIE J DELBRIDGE3 | 1924 E FOXBOROUGH CT HAYDEN, ID 83835 | CONTINENTAL AMERICAN INSURANCE COMPANY | $224 | $0 | $224 | 0.89% |
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 | 138 | 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) | 138 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | PREMERA BLUE CROSS | 156 | $1.4M |
| Dental | PREMERA BLUE CROSS | 156 | $1.4M |
| Vision | PREMERA BLUE CROSS | 156 | $1.4M |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 168 | $35K |
| Prescription drug | PREMERA BLUE CROSS | 156 | $1.4M |
| Other(2 contracts, 2 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 168 | $60K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 168 | — |
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.