| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| EBI3 | P.O. BOX 1440 MERCER ISLAND, WA 98040 | COMPANION LIFE INSURANCE CO. | $19K | — | $19K | 10.00% |
| COASTAL ADMINISTRATIVE SVCS INC5 Filed as: COASTAL ADMINISTRATIVE SERVICES | P.O. BOX 3070 BELLINGHAM, WA 98227 | COMPANION LIFE INSURANCE CO. | $10K | — | $10K | 5.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| IISI EIN 94-2872506 NONE | Claims processing Service code 12 | — | $166K |
| C.A.S. EIN 91-1991574 NONE | Contract Administrator Service code 13 | — | $117K |
| EMPLOYEE BENEFITS EIN 91-1591492 NONE | Consulting (general) Service code 16 | — | $57K |
| 6 DEGREES EIN 81-4242649 NONE | Contract Administrator Service code 13 | — | $53K |
| ASSUREDPARTNERS OF WASHINGTON, LLC EIN 45-2712335 NONE | Consulting (general) Service code 16 | — | $33K |
| ASSUREDPARTNERS EIN 45-2712335 NONE | Consulting (general) Service code 16 | — | $9K |
| AMERICAN HEALTH HOLDINGS EIN 31-1368946 NONE | Other services Service code 49 | — | $7K |
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 | 188 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 11 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 202 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Stop-loss / reinsurancereinsurance | COMPANION LIFE INSURANCE CO. | 188 | $190K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 188 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.