| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PARKER SMITH & FEEK INC.3 Filed as: PARKER, SMITH & FEEK INC. | 2233 112TH AVENUE NE BELLEVUE, WA 98004 | UNITED HEALTHCARE INSURANCE COMPANY | $3 | — | $3 | 0.02% |
| KEVIN OVERBEY3 | 720 OLIVE WAY, SUITE 1700 SEATTLE, WA 98101 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $36 | — | $36 | 0.75% |
| USI INSURANCE SERVICES LLC3 Filed as: KIBBLE & PRENTICE HOLDING COMPANY | 601 UNION STREET, SUITE 1000 SEATTLE, WA 98101 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $28 | — | $28 | 0.59% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES INC. | 701 B STREET, 6TH FLOOR SAN DIEGO, CA 92101 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $22 | — | $22 | 0.46% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS LLC | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $14 | — | $14 | 0.29% |
| PARKER SMITH & FEEK INC.3 Filed as: PARKER, SMITH & FEEK INC. | 2233 112TH AVENUE NE BELLEVUE, WA 98004 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $2 | — | $2 | 0.04% |
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 | 242 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 243 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF WASHINGTON | 209 | $118K |
| Vision | UNITED HEALTHCARE INSURANCE COMPANY | 259 | $17K |
| Life insurance | UNITED HEALTHCARE INSURANCE COMPANY | 242 | $38K |
| Short-term disability | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 9 | $5K |
| Long-term disability | UNITED HEALTHCARE INSURANCE COMPANY | 242 | $38K |
| Other | UNITED HEALTHCARE INSURANCE COMPANY | 242 | $38K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 259 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.