| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | 777 108TH AVENUE NE, SUITE 200 BELLEVUE, WA 98004 | REGENCE BLUESHIELD | $11K | — | $11K | 3.32% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 777 108TH AVENUE NE, SUITE 200 BELLEVUE, WA 98004 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $6K | — | $6K | 11.20% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 777 108TH AVENUE NE, SUITE 200 BELLEVUE, WA 98004 | STANDARD INSURANCE COMPANY | $4K | — | $4K | 21.89% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 505 NORTH BRAND BOULEVARD GLENDALE, CA 91203 | STANDARD INSURANCE COMPANY | — | $439 | $439 | 2.38% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 777 108TH AVENUE NE, SUITE 200 BELLEVUE, WA 98004 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | — | $2K | 22.31% |
| GALLAGHER BENEFIT SERVICES, INC.3 | TWO PIERCE PLACE, 14TH FLOOR ITASCA, IL 60143 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $96 | $96 | 1.20% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 777 108TH AVENUE NE, SUITE 200 BELLEVUE, WA 98004 | VISION SERVICE PLAN | $572 | — | $572 | 9.99% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 777 108TH AVENUE NE, SUITE 200 BELLEVUE, WA 98004 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $173 | — | $173 | 51.03% |
| GALLAGHER BENEFIT SERVICES, INC.3 | TWO PIERCE PLACE, 14TH FLOOR ITASCA, IL 60143 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | — | $10 | $10 | 2.95% |
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 | 121 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | 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) | REGENCE BLUESHIELD | 106 | $332K |
| Dental | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 79 | $54K |
| Vision | VISION SERVICE PLAN | 47 | $6K |
| Life insurance | STANDARD INSURANCE COMPANY | 121 | $18K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 79 | $54K |
| Prescription drug | REGENCE BLUESHIELD | 106 | $332K |
| Other(3 contracts, 3 carriers) | STANDARD INSURANCE COMPANY | 121 | $27K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 121 | — |
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.