| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 Filed as: ACRISURE NORTHWEST PARTNERS INSURAN | 19401 40TH AVE W STE 440 LYNNWOOD, WA 98036 | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON OPTIONS, INC. | $18K | — | $18K | 4.09% |
| ACRISURE LLC3 Filed as: ACRISURE NORTHWEST PARTNERS INSURAN | 19401 40TH AVE W STE 440 LYNNWOOD, WA 98036 | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON | $11K | — | $11K | 3.66% |
| BELL-ANDERSON AGENCY INC3 Filed as: BELL ANDERSON AGENCY | ATTN GHB 676B WOODLAND SQUIRE LOOP SE LACY, WA 98501 | STANDARD INSURANCE COMPANY | $4K | — | $4K | 5.00% |
| BELL-ANDERSON AGENCY INC3 Filed as: BELL ANDERSON AGENCY | ATTN GHB STE 410 676B WOODLAND SQUIRE LOOP SE LACY, WA 98507 | STANDARD INSURANCE COMPANY | $3K | — | $3K | 14.96% |
| GHB INC3 | PO BOX 1608 OLYMPIA, WA 98507 | BENEFIT INTELLIGENCE | $122 | — | $122 | — |
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 | 168 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 168 | 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. | 60 | $730K |
| Dental | STANDARD INSURANCE COMPANY | 104 | $79K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 136 | $9K |
| Life insurance | STANDARD INSURANCE COMPANY | 122 | $19K |
| Other(3 contracts, 3 carriers) | STANDARD INSURANCE COMPANY | 168 | $26K |
| 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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.