| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| AXIS INSURANCE LLC3 Filed as: AXIS INSURANCE, LLC | 155 108TH AVE NE STE 725 BELLEVUE, WA 98004 | AETNA LIFE INSURANCE COMPANY | $25K | — | $25K | 1.55% |
| AXIS INSURANCE LLC3 Filed as: AXIS INSURANCE, LLC | 155 108TH AVE NE STE 725 BELLEVUE, WA 98004 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $3K | — | $3K | 15.00% |
| AXIS INSURANCE LLC3 Filed as: AXIS INSURANCE, LLC | 155 108TH AVE NE STE 725 BELLEVUE, WA 98004 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $2K | — | $2K | 15.00% |
| AXIS INSURANCE LLC3 Filed as: AXIS INSURANCE, LLC | 155 108TH AVE NE STE 725 BELLEVUE, WA 98004 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $1K | — | $1K | 15.00% |
| AXIS INSURANCE LLC3 Filed as: AXIS INSURANCE, LLC | 155 108TH AVE NE STE 725 BELLEVUE, WA 98004 | THE LINCOLN NATIONAL LIFE INSUANCE COMPANY | $1K | — | $1K | 15.00% |
| NAVIA BENEFIT SOLUTIONS INC.5 | PO BOX 53250 BELLEVUE, WA 98015 | NAVIA BENEFIT SOLUTIONS INC. | — | $6K | $6K | — |
| NAVIA BENEFIT SOLUTIONS INC.5 | PO BOX 53250 BELLEVUE, WA 98015 | NAVIA BENEFIT SOLUTIONS INC. | — | $3K | $3K | — |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| NAVIA BENEFIT SOLUTIONS INC. EIN 91-1467758 PLAN ADMINISTRATOR | Claims processing Service code 12 | PO BOX 53250 BELLEVUE, WA 98015 | $0 |
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. |
| Total participants (= "Plan participants" tile) | 115 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | AETNA LIFE INSURANCE COMPANY | 233 | $1.6M |
| Dental | AETNA LIFE INSURANCE COMPANY | 233 | $1.6M |
| Life insurance(2 contracts, 2 carriers) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 104 | $19K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 104 | $20K |
| Other(5 contracts, 3 carriers) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 114 | $28K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 233 | — |
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.