| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARK WILLIAM FRITZEN3 | PO BOX 70025 VANCOUVER, WA 98665 | AETNA LIFE INSURANCE COMPANY | $2K | $25K | $27K | 1.90% |
| MARK WILLIAM FRITZEN3 | 3713 NE 80TH STREET VANCOUVER, WA 98665 | AETNA LIFE INSURANCE COMPANY | $2K | $17K | $19K | 1.30% |
| MARK WILLIAM FRITZEN3 Filed as: MARK FRITZEN | 10705 NE 25 PLACE VANCOUVER, WA 98686 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $7K | $0 | $7K | 14.06% |
| JENNON CARUTH3 | PO BOX 46122 EDEN PRAIRIE, MN 55344 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | $238 | $3K | 6.65% |
| THOMAS W. MAYER3 Filed as: THOMAS MAYER | 55 EAST 5TH STREET, SUITE 500 ST. PAUL, MN 55101 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $155 | $0 | $155 | 0.30% |
| DIRECT BENEFITS INC3 Filed as: DIRECT BENEFITS | 7900 INTERNATIONAL DRIVE SUITE 1040 BLOOMINGTON, MN 55425 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $114 | $0 | $114 | 0.22% |
| JENNON CARUTH3 | PO BOX 46122 EDEN PRAIRIE, MN 55344 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $574 | $33 | $607 | 22.55% |
| MARK WILLIAM FRITZEN3 Filed as: MARK FRITZEN | 10705 NE 25 PLACE VANCOUVER, WA 98686 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $3 | $0 | $3 | 0.11% |
| THOMAS W. MAYER3 Filed as: THOMAS MAYER | 55 EAST 5TH STREET, SUITE 500 ST. PAUL, MN 55101 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $0 | $0 | $0 | 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 | 144 | 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) | 144 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | AETNA LIFE INSURANCE COMPANY | 185 | $1.4M |
| Dental | AETNA LIFE INSURANCE COMPANY | 185 | $1.4M |
| Life insurance(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 176 | $55K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 176 | $52K |
| Prescription drug | AETNA LIFE INSURANCE COMPANY | 185 | $1.4M |
| Other | UNUM LIFE INSURANCE COMPANY OF AMERICA | 176 | $52K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 185 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.