| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| FLEXIBLE BENEFITS CORPORATION3 | 6901 6TH AVE TACOMA, WA 98406 | HCC LIFE INSURANCE COMPANY | $51K | — | $51K | 11.93% |
| CAMBRIAN CONSULTING, INC.0 Filed as: CAMBRIAN CONSULTING INC | 10234 NE 183RD ST STE 102 BOTHELL, WA 98011 | HCC LIFE INSURANCE COMPANY | — | $6K | $6K | 1.32% |
| CONOVER INSURANCE SERVICES LLC3 | 125 N 50TH AVE YAKIMA, WA 98908 | PRINCIPAL LIFE INSURANCE COMPANY | $11K | $2K | $13K | 9.84% |
| CONOVER INSURANCE SERVICES LLC3 | PO BOX 10088 YAKIMA, WA 98909 | VISION SERVICE PLAN | $820 | — | $820 | 6.86% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| TRUSTED PLANS SERVICE CORP EIN 91-0780588 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | — | $37K |
| FIRST CHOICE EIN 91-1272766 PREFERRED PROVIDER | Other services Service code 49 | — | $5K |
| AMERICAN HEALTH HOLDING EIN 31-1367946 UTILIZATION REVIEW SER | Other services Service code 49 | — | $2K |
| FIRST HEALTH EIN 20-1736437 PREFERRED PROVIDER ORG | Other services Service code 49 | — | $2K |
| CONOVER BENEFITS EIN 91-1020209 12741 | Insurance agents and brokers Service code 22 | — | $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 | 150 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 150 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HCC LIFE INSURANCE COMPANY | 142 | $424K |
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 150 | $128K |
| Vision | VISION SERVICE PLAN | 145 | $12K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 150 | $128K |
| Long-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 150 | $128K |
| Stop-loss / reinsurancereinsurance | HCC LIFE INSURANCE COMPANY | 142 | $424K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 150 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.