| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BERG BENEFITS, INC.3 Filed as: BERG ANDONIAN INC. | P.O. BOX 66029 TACOMA, WA 98464 | DELTA DENTAL OF WASHINGTON | $12K | — | $12K | 7.59% |
| BERG BENEFITS, INC.3 Filed as: BERG ANDONIAN INC. | P.O. BOX 66029 TACOMA, WA 98464 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | — | $3K | 15.00% |
| BERG BENEFITS, INC.3 Filed as: BERG ANDONIAN INC. | P.O. BOX 66029 TACOMA, WA 98464 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | — | $3K | 15.00% |
| BERG BENEFITS, INC.3 Filed as: BERG ANDONIAN INC. | P.O. BOX 66029 TACOMA, WA 98464 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 15.00% |
| BERG BENEFITS, INC.3 Filed as: BERG ANDONIAN INC. | P.O. BOX 66029 TACOMA, WA 98464 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $877 | — | $877 | 15.01% |
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 | 149 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 152 | 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. | 144 | $1.3M |
| Dental | DELTA DENTAL OF WASHINGTON | 211 | $155K |
| Vision(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON OPTIONS, INC. | 144 | $1.3M |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 149 | $32K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 25 | $6K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 130 | $20K |
| Other(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 149 | $32K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 211 | — |
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."
No prospect flags tripped on this filing.