| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| SERVCO INSURANCE SERVICES CORP3 Filed as: SERVCO INSURANCE SERVICES WA LLC | 800 5TH AVENUE, SUITE 2400 SEATTLE, WA 98104 | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON OPTIONS, INC. | $21K | $0 | $21K | 1.64% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN AND BROWN OF WASHINGTON, INC. | 800 5TH AVENUE, SUITE 2400 SEATTLE, WA 98104 | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON OPTIONS, INC. | $16K | $0 | $16K | 1.25% |
| SERVCO INSURANCE SERVICES CORP3 Filed as: SERVCO INSURANCE SERVICES WA LLC | 1100 DEXTER AVENUE NORTH, SUITE 220 SEATTLE, WA 98109 | DELTA DENTAL OF WASHINGTON | $6K | $0 | $6K | 5.00% |
| SERVCO INSURANCE SERVICES CORP3 Filed as: SERVCO INSURANCE SERVICES WA LLC | 800 5TH AVENUE, SUITE 2400 SEATTLE, WA 98104 | VISION SERVICE PLAN | $656 | $0 | $656 | 6.76% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN AND BROWN OF WASHINGTON, INC. | 800 5TH AVENUE, SUITE 2400 SEATTLE, WA 98104 | VISION SERVICE PLAN | $79 | $0 | $79 | 0.81% |
| SERVCO INSURANCE SERVICES CORP3 Filed as: SERVCO INSURANCE SERVICES WA LLC | 800 5TH AVENUE, SUITE 2400 SEATTLE, WA 98104 | AETNA LIFE INSURANCE COMPANY | $2K | $152 | $3K | 50.66% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN AND BROWN OF WASHINGTON, INC. | 1501 4TH AVENUE, SUITE 2400 SEATTLE, WA 98101 | AETNA LIFE INSURANCE COMPANY | $521 | $0 | $521 | 10.00% |
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 | 136 | 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) | 136 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON OPTIONS, INC. | 218 | $1.3M |
| Dental | DELTA DENTAL OF WASHINGTON | 184 | $118K |
| Vision | VISION SERVICE PLAN | 97 | $10K |
| Life insurance | AETNA LIFE INSURANCE COMPANY | 136 | $5K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON OPTIONS, INC. | 218 | $1.3M |
| Other | AETNA LIFE INSURANCE COMPANY | 136 | $5K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 218 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.