| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| R.L. EVANS COMPANY, INC.3 | 3535 FACTORIA BLVD SE, STE 120 BELLEVUE, WA 98006 | GROUP HEALTH OPTIONS | $30K | — | $30K | 2.33% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES, INC | 1420 5TH AVE., SUITE 1500 SEATLTE, WA 98101 | GROUP HEALTH OPTIONS | $13K | — | $13K | 0.98% |
| R.L. EVANS COMPANY, INC.3 | 3535 FACTORIA BLVD SE, STE 120 BELLEVUE, WA 98006 | GROUP HEALTH OPTIONS, INC. | $12K | — | $12K | 1.79% |
| ALLIANT INSURANCE SERVICES, INC.3 | 1420 5TH AVE, SUITE 1500 SEATTLE, WA 98101 | GROUP HEALTH OPTIONS, INC. | $5K | — | $5K | 0.78% |
| ALLIANT INSURANCE SERVICES, INC.3 | 1301 DOVE ST., SUITE 200 NEWPORT BEACH, CA 92260 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $829 | $129 | $958 | 5.13% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES | 1301 DOVE ST., STE 200 NEWPORT BEACH, CA 92660 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $390 | $76 | $466 | 3.99% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| AMERITAS LIFE INSURANCE EIN 47-0098400 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | — | $14K |
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 | 500 | 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) | 503 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts) | GROUP HEALTH OPTIONS | 235 | $2.0M |
| Vision | AMERITAS LIFE INSURANCE CORP | 89 | $8K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 500 | $19K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 500 | $19K |
| Other | UNUM LIFE INSURANCE COMPANY OF AMERICA | 41 | $12K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 500 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.