| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CONOVER INSURANCE SERVICES LLC3 | PO BOX 10088 YAKIMA, WA 98909 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $1K | $1K | $2K | 4.07% |
| CONOVER INSURANCE SERVICES LLC3 Filed as: CONOVER INSURANCE SERVICES, LLC | PO BOX 10088 YAKIMA, WA 98909 | PRINCIPAL LIFE INSURANCE COMPANY | $3K | — | $3K | 8.82% |
| CONOVER INSURANCE SERVICES LLC3 | PO BOX 10088 YAKIMA, WA 98909 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $4K | $991 | $5K | 18.74% |
| CONOVER INSURANCE SERVICES LLC3 Filed as: CONOVER INSURANCE SERVICES, LLC | PO BOX 10088 YAKIMA, WA 98909 | VISION SERVICE PLAN | $847 | — | $847 | 6.68% |
| CONOVER INSURANCE SERVICES LLC3 | PO BOX 10088 YAKIMA, WA 98909 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $1K | $382 | $2K | 19.04% |
| CONOVER INSURANCE SERVICES LLC3 | PO BOX 10088 YAKIMA, WA 98909 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $843 | $215 | $1K | 18.83% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| TRUSTEED PLANS SERVICE CORPORATION EIN 91-0780588 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | — | $45K |
| CONOVER BENEFITS EIN 91-1020209 INSURANCE BROKER | Insurance agents and brokers Service code 22 | — | $40K |
| FIRST CHOICE EIN 91-1272766 PREFERRED PROVIDER ORG | Other services Service code 49 | — | $6K |
| FIRST HEALTH EIN 20-1736437 PREFERRED PROVIDER ORG. | Other services Service code 49 | — | $2K |
| AMERICAN HEALTH HOLDING EIN 31-1367946 UTILIZATION REVIEW SERV. | Other services Service code 49 | — | $2K |
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 | 153 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 153 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | QBE INSURANCE | 146 | $332K |
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 153 | $35K |
| Vision | VISION SERVICE PLAN | 149 | $13K |
| Life insurance(3 contracts, 2 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 153 | $67K |
| Long-term disability(2 contracts, 2 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 153 | $44K |
| Stop-loss / reinsurancereinsurance | QBE INSURANCE | 146 | $332K |
| Other(2 contracts) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 151 | $32K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 153 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.