| 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. | $16K | — | $16K | 1.96% |
| 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 | $4K | — | $4K | 2.03% |
| UNITED INSURANCE BROKERS INC3 Filed as: UNITED INSURANCE BROKERS | 3150 RICHARDS ROAD SUITE 170 BELLEVUE, WA 98005 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $12K | — | $12K | 6.77% |
| BARBARA M DICKSON3 | 8151 164TH AVENUE NE #411 REDMOND, WA 98052 | AFLAC | $891 | — | $891 | 4.22% |
| UNITED INSURANCE BROKERS INC3 | 50 116TH AVE SE SUITE 201 BELLEVUE, WA 98004 | AFLAC | $687 | — | $687 | 3.25% |
| NORTHWEST BENEFIT ADVISORS, INC.3 Filed as: NORTHWEST BENEFIT ADVISORS, INC | 8151 164TH AVENUE NE #411 REDMOND, WA 98052 | AFLAC | $297 | — | $297 | 1.41% |
| DEBORAH R. WALLACE3 Filed as: DEBORAH R WALLACE | 3320 GRAVELLY BEACH LOOP NW OLYMPIA, WA 98502 | AFLAC | $158 | — | $158 | 0.75% |
| SANDRA M LOHNES3 | P.O. BOX 678 EASTON, WA 98925 | AFLAC | $131 | — | $131 | 0.62% |
| BRAD FISHER3 | 819 W PRAIRIE STREET SULLIVAN, IL 61951 | AFLAC | $99 | — | $99 | 0.47% |
| DAVID J MCCLELLAN3 Filed as: DAVID JOHN HANNANT | 14830 NE 167TH STREET WOODINVILLE, WA 98072 | AFLAC | $93 | — | $93 | 0.44% |
| ELIZABETH D PEARSON3 | 4609 103RD LANE NE KIRKLAND, WA 98033 | AFLAC | $87 | — | $87 | 0.41% |
| AMANDA M GRIFFITH3 | 11400 SE 8TH STREET #875 BELLEVUE, WA 98004 | AFLAC | $85 | — | $85 | 0.40% |
| CAROL ANNE BROGAN KEETON3 | 485 NICOLE DRIVE BLACKFOOT, ID 83221 | AFLAC | $60 | — | $60 | 0.28% |
| JACOB J MCINTOSH3 | 665 S WOODRUFF AVENUE SUITE 250 IDAHO FALLS, OH 83401 | AFLAC | $53 | — | $53 | 0.25% |
| MARY L. JOCHUM3 Filed as: MARY L JOCHUM | 1200 179TH PLACE NE BELLEVUE, WA 98008 | AFLAC | $29 | — | $29 | 0.14% |
| SHERRIE JANE NELSON3 | 8180 W 4TH AVENUE APT. B103 KENNEWICK, WA 99336 | AFLAC | $21 | — | $21 | 0.10% |
| CRAIG A HANSEN3 | 6848 RIVERDALE DRIVE SE TUMWATER, WA 98501 | AFLAC | $10 | — | $10 | 0.05% |
| MICHAEL C WALKER3 Filed as: MICHAEL A STACHOWIAK | 321 N CLARK STREET SUITE 615 CHICAGO, IL 60654 | AFLAC | $10 | — | $10 | 0.05% |
| SUWAT ASSAWAMATIYANONT3 | 8171 HAMPTON WOOD DRIVE BOCA RATON, FL 33433 | AFLAC | $10 | — | $10 | 0.05% |
| HEATHER L TOMSON3 | 63607 NE 9TH STREET RENTON, WA 98056 | AFLAC | $8 | — | $8 | 0.04% |
| SCOTT W BLACKSHEAR3 | 181 OLETA WAY ST. AUGUSTINE, FL 32095 | AFLAC | $6 | — | $6 | 0.03% |
| DARAN L WYCKOFF3 | 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% |
| KRISTINE G WYCKOFF3 | P.O. 31233 SPOKANE, WA 99223 | AFLAC | $1 | — | $1 | 0.00% |
| KRISTEN SUE PLAISANCE3 | 11315 E 12TH AVENUE SPOKANE VALLEY, WA 99206 | 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 | 115 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 117 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON OPTIONS, INC. | 113 | $1.0M |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 115 | $173K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 115 | $173K |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 115 | $173K |
| Short-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 115 | $173K |
| Long-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 115 | $173K |
| Other(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 115 | $194K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 115 | — |
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.