| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| UNITED INSURANCE BROKERS INC3 Filed as: UNITED INSURANCE BROKERS, INC. | 127 BELLEVUE WAY SE SUITE 108 BELLEVUE, WA 98004 | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON OPTIONS, INC. | $19K | $64 | $19K | 1.99% |
| UNITED INSURANCE BROKERS INC3 Filed as: UNITED INSURANCE BROKERS | 127 BELLEVUE WAY SUITE 108 BELLEVUE, WA 98004 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $12K | — | $12K | 6.75% |
| BARBARA M DICKSON3 Filed as: BARBARA M. DICKSON | 8151 164TH AVENUE NE #411 REDMOND, WA 98052 | AFLAC | $629 | — | $629 | 2.78% |
| UNITED INSURANCE BROKERS INC3 Filed as: UNITED INSURANCE BROKERS, INC. | 50 116TH AVENUE SE SUITE 201 BELLEVUE, WA 98004 | AFLAC | $513 | — | $513 | 2.27% |
| BARBARA M DICKSON3 Filed as: BARBARA M. DICKSON | 8040 161ST AVENUE NE #411 REDMOND, WA 98052 | AFLAC | $199 | — | $199 | 0.88% |
| SANDRA M LOHNES3 Filed as: SANDRA M. LOHNES | P.O. BOX 678 EASTON, WA 98925 | AFLAC | $169 | — | $169 | 0.75% |
| DEBORAH R. WALLACE3 | 3320 GRAVELLY BEACH LOOP NW OLYMPIA, WA 98502 | AFLAC | $158 | — | $158 | 0.70% |
| NORTHWEST BENEFIT ADVISORS, INC.3 | 8151 164TH AVENUE NE #411 REDMOND, WA 98052 | AFLAC | $147 | — | $147 | 0.65% |
| DAVID J MCCLELLAN3 Filed as: DAVID JOHN HANNANT | 14830 NE 167TH STREET WOODINVILLE, WA 98072 | AFLAC | $113 | — | $113 | 0.50% |
| BRAD FISHER3 | 8908 NE 145TH STREET KENMORE, WA 98028 | AFLAC | $103 | — | $103 | 0.46% |
| AMANDA M GRIFFITH3 Filed as: AMANDA M. GRIFFITH | 11400 SE 8TH STREET #875 BELLEVUE, WA 98004 | AFLAC | $94 | — | $94 | 0.42% |
| ELIZABETH D PEARSON3 Filed as: ELIZABETH D. PEARSON | 4609 103RD LANE NE KIRKLAND, WA 98033 | AFLAC | $87 | — | $87 | 0.38% |
| JACOB J MCINTOSH3 Filed as: JACOB J. MCINTOSH | 665 S WOODRUFF AVENUE SUITE 250 IDAHO FALLS, ID 83401 | AFLAC | $53 | — | $53 | 0.23% |
| MARY L. JOCHUM3 | 1200 179TH PLACE NE BELLEVUE, WA 98008 | AFLAC | $39 | — | $39 | 0.17% |
| SHERRIE JANE NELSON3 | 3002 S VANCOUVER STREET KENNEWICK, WA 99337 | AFLAC | $21 | — | $21 | 0.09% |
| MICHAEL C WALKER3 Filed as: MICHAEL A. STACHOWIAK | 321 N CLARK STREET SUITE 615 CHICAGO, IL 60654 | AFLAC | $10 | — | $10 | 0.04% |
| SUWAT ASSAWAMATIYANONT3 | 8171 HAMPTON WOOD DRIVE BOCA RATON, FL 33433 | AFLAC | $10 | — | $10 | 0.04% |
| CRAIG A HANSEN3 Filed as: CRAIG A. HANSEN | 6848 RIVERDALE DRIVE SE TUMWATER, WA 98501 | AFLAC | $10 | — | $10 | 0.04% |
| HEATHER L TOMSON3 Filed as: HEATHER L. TOMSON | 63607 NE 9TH STREET RENTON, WA 98056 | AFLAC | $8 | — | $8 | 0.04% |
| MARY L. JOCHUM3 | 8920 132ND PLACE SE NEWCASTLE, WA 98059 | AFLAC | $8 | — | $8 | 0.04% |
| SCOTT W BLACKSHEAR3 Filed as: SCOTT W. BLACKSHEAR | 181 OLETA WAY ST. AUGUSTINE, FL 32095 | AFLAC | $7 | — | $7 | 0.03% |
| DARAN L WYCKOFF3 Filed as: DARAN L. WYCKOFF | P.O. BOX 31233 SPOKANE, WA 99223 | AFLAC | $3 | — | $3 | 0.01% |
| CLIFF HARRISON BARROWS3 | 5716 S FERRALL STREET SPOKANE, WA 99223 | AFLAC | $2 | — | $2 | 0.01% |
| KRISTEN SUE PLAISANCE3 | 11315 E 12TH AVENUE SPOKANE VALLEY, WA 99206 | AFLAC | $1 | — | $1 | 0.00% |
| KRISTINE G WYCKOFF3 | P.O. BOX 31233 SPOKANE, WA 99223 | AFLAC | $1 | — | $1 | 0.00% |
No Schedule C service providers reported on this filing.
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 | 116 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 116 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON OPTIONS, INC. | 142 | $961K |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 116 | $175K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 116 | $175K |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 116 | $175K |
| Short-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 116 | $175K |
| Long-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 116 | $175K |
| Other(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 116 | $198K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 142 | — |
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."
No prospect flags tripped on this filing.