| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES | 720 OLIVE WAY STE 1700 SEATTLE, WA 98101 | DELTA DENTAL OF WASHINGTON | $5K | — | $5K | 4.56% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES INC | STE 1500 1420 5TH AVE SEATTLE, WA 98101 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4K | $619 | $5K | 14.81% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES INC | ATTN ERICA MENDEZ 1301 DOVE ST STE 200 NEWPORT BEACH, CA 92660 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | — | $0 | 0.00% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES INC | STE 1500 1420 5TH AVE SEATTLE, WA 98101 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | $443 | $4K | 17.00% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES INC | ATTN ERICA MENDEZ 1301 DOVE ST STE 200 NEWPORT BEACH, CA 92660 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | — | $0 | 0.00% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES | 701 B ST FL 6 SAN DIEGO, CA 921018156 | VISION SERVICE PLAN | $1K | — | $1K | 5.40% |
| JUDY INEZ BUCHOLTZ3 Filed as: JUDY I BUCHOLTZ | 12517-217TH AVE CT E BONNEY LAKE, WA 98391 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $285 | $2K | 8.18% |
| WHITFIELDS UNITED INSURANCE AGENCIE3 | PMB 325 UNIVERSITY PI, WA 98466 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $587 | — | $587 | 3.02% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES INC | 701 B ST SAN DIEGO, CA 92101 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $425 | $32 | $457 | 2.35% |
| MARK CHARLES MORGAN3 | 2590 WILLAMETTE DRIVE NE LACEY, WA 98516 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $65 | $140 | $205 | 1.06% |
| CORRY AGENCY, INC.3 Filed as: CORRY AGENCY INC | PO BOX 950 GIG HARBOR, WA 98335 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $42 | — | $42 | 0.22% |
| TAI D SHIN3 | 2950 POPPY LANE SW TUMWATER, WA 98512 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $11 | $22 | $33 | 0.17% |
| HR BENEFITS SERVICES, INC.3 Filed as: NW BENEFITS GROUP LLC | 3104 MCALLISTER ST DUPONT, WA 98327 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $19 | — | $19 | 0.10% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES, INC | 1420 5TH AVENUE SEATTLE, WA 98101 | NATIONAL UNION FIRE INS CO OF PITTSBURGH, PA | $0 | — | $0 | 0.00% |
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 | 123 | 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) | 123 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 123 | $33K |
| Dental | DELTA DENTAL OF WASHINGTON | 216 | $107K |
| Vision | VISION SERVICE PLAN | 123 | $21K |
| Life insurance(3 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 123 | $72K |
| Short-term disability | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 22 | $19K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 123 | $31K |
| Other(4 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 123 | $86K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 216 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.