| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | SUN LIFE ASSURANCE COMPANY OF CANADA | $10K | — | $10K | 3.77% |
| LOCKTON COMPANIES, LLC3 | PO BOX 650823 DALLAS, TX 75265 | SUN LIFE ASSURANCE COMPANY OF CANADA | $3K | — | $3K | 1.23% |
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | VISION SERVICE PLAN | $2K | — | $2K | 3.95% |
| DAVID ROJAS3 | 169 EAGLE RIDGE DRIVE E PUYALLUP, WA 98374 | CONTINENTAL AMERICAN INSURANCE COMPANY | $1K | — | $1K | 8.23% |
| ALLIANT INSURANCE SERVICES, INC.3 | 818 WEST RIVERSIDE AVENUE, SUITE 800 SPOKANE, WA 99201 | CONTINENTAL AMERICAN INSURANCE COMPANY | $558 | — | $558 | 3.12% |
| TRISHAWNA SCOTT HAYES3 Filed as: TRISHAWNA Y SCOTT-HAYES | 12014 133 ROAD STREET E, SUITE 301 PUYALLUP, WA 98374 | CONTINENTAL AMERICAN INSURANCE COMPANY | $422 | — | $422 | 2.36% |
| KYONG H. GOINS3 Filed as: KYONG H GOINS | 2931 1ST AVENUES, SUITE A SEATTLE, WA 98134 | CONTINENTAL AMERICAN INSURANCE COMPANY | $393 | — | $393 | 2.20% |
| JEFF DALABA3 Filed as: JEFF CLACK | 4425 HARBOR COUNTRY DRIVE, APT L85 GIG HARBOR, WA 98335 | CONTINENTAL AMERICAN INSURANCE COMPANY | $242 | — | $242 | 1.36% |
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | CONTINENTAL AMERICAN INSURANCE COMPANY | $160 | — | $160 | 0.90% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| PREMERA BLUE CROSS EIN 91-0499247 ADMINISTRATOR | Contract Administrator Service code 13 | — | $212K |
| SUN LIFE ASSURANCE CO. OF CANADA EIN 38-1082080 ADMINISTRATOR | Contract Administrator Service code 13 | — | $17K |
| FIRST CHOICE HEALTH EIN 91-1272766 ADMINISTRATOR | Contract Administrator Service code 13 | — | $10K |
| NAVIA BENEFIT SOLUTIONS EIN 91-1467758 ADMINISTRATOR | Contract Administrator Service code 13 | — | $10K |
| LOCKTON COMPANIES, LLC BROKER | Insurance agents and brokers Service code 22 | 444 WEST 47TH ST., 900 KANSAS CITY, MO 64112 | $0 |
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 | 488 | 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) | 488 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | VISION SERVICE PLAN | 344 | $44K |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 486 | $260K |
| Short-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 486 | $260K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 486 | $260K |
| Other(2 contracts, 2 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 486 | $278K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 486 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.