| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 Filed as: ACRISURE NW PARTNERS INS. | 19401 40TH AVENUE WEST, SUITE 440 LYNWOOD, WA 98036 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $69K | $0 | $69K | 3.45% |
| BELL-ANDERSON AGENCY INC3 Filed as: BELL-ANDERSON AGENCY INC. | 19401 40TH AVENUE WEST, SUITE 440 LYNNEWOOD, WA 98036 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $32K | $0 | $32K | 1.61% |
| ACRISURE LLC3 Filed as: ACRISURE NW PARTNERS INS. | 19401 40TH AVENUE WEST, SUITE 440 LYNWOOD, WA 98036 | DELTA DENTAL OF WASHINGTON | $8K | $0 | $8K | 5.00% |
| ACRISURE LLC3 Filed as: ACRISURE NW PARTNERS INS. | 19401 40TH AVENUE WEST, SUITE 440 LYNWOOD, WA 98036 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $11K | $3K | $14K | 13.61% |
| GROUP BENEFITS LTD3 | 12006 RIDGEMONT DRIVE URBANDALE, IA 50323 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $5K | $5K | 5.00% |
| BELL-ANDERSON AGENCY INC3 Filed as: BELL-ANDERSON AGENCY INC. | 676B WOODLAND SQUARE LOOP SE SUITE 410 LACEY, WA 98503 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $923 | $0 | $923 | 0.92% |
| ACRISURE LLC3 Filed as: ACRISURE NW PARTNERS INS. | 19401 40TH AVENUE WEST, SUITE 440 LYNWOOD, WA 98036 | WILLAMETTE DENTAL OF WASHINGTON, INC. | $749 | $0 | $749 | 4.20% |
| GROUP BENEFITS LTD3 Filed as: GROUP BENEFITS, LTD | 12006 RIDGEMONT DRIVE URBANDALE, IA 50323 | VISION SERVICE PLAN | $699 | — | $699 | 4.00% |
| ACRISURE LLC3 Filed as: ACRISURE NW PARTNERS INS. | 19401 40TH AVENUE WEST, SUITE 440 LYNWOOD, WA 98036 | VISION SERVICE PLAN | $551 | $0 | $551 | 3.15% |
| BELL-ANDERSON AGENCY INC3 Filed as: BELL-ANDERSON AGENCY | 100 OTTAWA AVENUE SW GRAND RAPIDS, MI 49503 | VISION SERVICE PLAN | $493 | — | $493 | 2.82% |
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 | 147 | 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) | 147 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 197 | $2.0M |
| Dental(2 contracts, 2 carriers) | DELTA DENTAL OF WASHINGTON | 266 | $174K |
| Vision | VISION SERVICE PLAN | 142 | $17K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 147 | $100K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 147 | $100K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 147 | $100K |
| Prescription drug | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 197 | $2.0M |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 147 | $100K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 266 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.