| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| R.L. EVANS COMPANY, INC.3 Filed as: R.L. EVANS COMPANY | 3535 FACTORIA BLVD SE STE 120 BELLEVUE, WA 98006 | SUN LIFE ASSURANCE COMPANY OF CANADA | — | $4K | $4K | 1.26% |
| R.L. EVANS COMPANY, INC.3 | 3535 FACTORIA BLVD SE, STE 120 BELLEVUE, WA 98006 | SUN LIFE ASSURANCE COMPANY OF CANADA | $9K | — | $9K | 14.15% |
| R.L. EVANS COMPANY, INC.3 | 3535 FACTORIA BLVD SE #120 BELLEVUE, WA 98006 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | — | $2K | 10.00% |
| R.L. EVANS COMPANY, INC.3 Filed as: R. L. EVANS COMPANY, INC. | 3535 FACTORIA BLVD SE #120 BELLEVUE, WA 98006 | FIRST CHOICE HEALTH EAP | $2K | — | $2K | 14.84% |
| R.L. EVANS COMPANY, INC.3 | 3535 FACTORIA BLVD SE #120 BELLEVUE, WA 98006 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $907 | — | $907 | 10.00% |
| R.L. EVANS COMPANY, INC.3 | 3535 FACTORIA BLVD SE #120 BELLEVUE, WA 98006 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $834 | — | $834 | 10.00% |
| R.L. EVANS COMPANY, INC.3 | 3535 FACTORIA BLVD SE #120 BELLEVUE, WA 98006 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $216 | — | $216 | 9.99% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HEALTHCARE MANAGEMENT ADMINISTRATOR EIN 91-1333840 CONTRACT ADMIN | Contract Administrator Service code 13 | — | $89K |
| R.L. EVANS COMPANY, INC. EIN 91-0849754 BROKER | Insurance agents and brokers Service code 22 | — | $22K |
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 | 225 | 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) | 227 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance(2 contracts, 2 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 222 | $85K |
| Short-term disability(2 contracts, 2 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 222 | $76K |
| Long-term disability(2 contracts, 2 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 218 | $75K |
| Stop-loss / reinsurancereinsurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 225 | $358K |
| Other(3 contracts, 3 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 730 | $84K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 730 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.