| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WELLS FARGO INSURANCE SERVICES3 Filed as: WELLS FARGO INSURANCE SERVICES USA | 999 3RD AVE SUITE 4100 SEATTLE, WA 98104 | GROUP HEALTH COOPERATIVE | $50K | — | $50K | 3.91% |
| DIMARTINO ASSOCIATES3 | 1501 4TH AVE SUITE 2400 SEATTLE, WA 98101 | GROUP HEALTH COOPERATIVE | $15K | — | $15K | 1.15% |
| WELLS FARGO INSURANCE SERVICES3 | 999 3RD AVE SUITE 4100 SEATTLE, WA 98104 | GROUP HEALTH OPTIONS, INC. | $5K | — | $5K | 2.48% |
| DIMARTINO ASSOCIATES3 | 1501 4TH AVE SUITE 2400 SEATTLE, WA 98101 | GROUP HEALTH OPTIONS, INC. | $1K | — | $1K | 0.72% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF WASHINGTON | 1501 4TH AVE SUITE 2400 SEATTLE, WA 98101 | DELTA DENTAL OF WASHINGTON | $3K | — | $3K | 1.84% |
| WELLS FARGO INSURANCE SERVICES3 Filed as: WELLS FARGO INSURANCE SERVICES USA | 999 3RD AVE SUITE 4100 SEATTLE, WA 98104 | DELTA DENTAL OF WASHINGTON | $821 | — | $821 | 0.52% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF WASHINGTON INC | 1501 4TH AVE SUITE 2400 SEATTLE, WA 98101 | SUN LIFE ASSURANCE COMPANY OF CANADA | $670 | — | $670 | 2.59% |
| WELLS FARGO INSURANCE SERVICES3 Filed as: WELLS FARGO INSURANCE SERVICES USA | 999 3RD AVE SUITE 4100 SEATTLE, WA 98104 | SUN LIFE ASSURANCE COMPANY OF CANADA | $241 | — | $241 | 0.93% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF WASHINGTON INC | 1501 4TH AVE SUITE 2400 SEATTLE, WA 98101 | VISION SERVICE PLAN | $169 | — | $169 | 0.92% |
| WELLS FARGO INSURANCE SERVICES3 Filed as: WELLS FARGO INSURANCE SERVICES USA | 999 3RD AVE SUITE 4100 SEATTLE, WA 98104 | VISION SERVICE PLAN | $61 | — | $61 | 0.33% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| WELFARE & PENSION ADMINISTRATIVE SV EIN 91-1363171 NONE | Claims processing; Participant communication; Plan Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.); Contract Administrator; Direct payment from the plan Service code 12 | — | $109K |
| BROWN & BROWN OF WASHINGTON INC EIN 91-0378940 NONE | Consulting (general); Direct payment from the plan; Insurance services Service code 16 | — | $26K |
| LAW OFFICES OF JACK R BURNS EIN 91-0871145 NONE | Legal; Direct payment from the plan Service code 29 | — | $24K |
| CLIFTON LARSON ALLEN LLP EIN 41-0746749 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $16K |
| INTERNATIONAL FOUNDATION OF EBPS NONE | Other services; Direct payment from the plan Service code 49 | 18700 W. BLUEMOUND RD. BROOKFIELD, WI 53045 | $10K |
| BANK OF AMERICA, N.A. EIN 94-1687665 NONE | Soft dollars commissions; Custodial (securities); Investment management fees paid directly by plan; Investment management; Direct payment from the plan Service code 19 | — | $8K |
| MARSH & MCLENNAN AGENCY NONE | Direct payment from the plan; Insurance services Service code 23 | 360 HAMILTON AVENUE, SUITE 930 WHITE PLAINS, NY 10601 | $7K |
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 | 460 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 460 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | GROUP HEALTH COOPERATIVE | 267 | $1.5M |
| Dental | DELTA DENTAL OF WASHINGTON | 317 | $159K |
| Vision | VISION SERVICE PLAN | 316 | $18K |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 327 | $26K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 327 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.