| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF WASHINGTON | PO BOX 1718 TACOMA, WA 98401 | GROUP HEALTH COOPERATIVE | $90K | — | $90K | 3.39% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF WASHINGTON INC | PO BOX 1718 TACOMA, WA 98401 | GROUP HEALTH OPTIONS, INC. | $30K | — | $30K | 2.71% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF WA, INC | 2106 PACIFIC AVE STE. 501 TACOMA, WA 98402 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $14K | $4K | $18K | 8.57% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INSURANCE WASHINGTON | 2106 PACIFIC AVE TACOMA, WA 98402 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $9K | $1K | $10K | 17.52% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF WA, INC. | 2106 PACIFIC AVE STE 501 TACOMA, WA 98402 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $493 | — | $493 | 2.50% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF WASHINGTON | PO BOX 1718 TACOMA, WA 98401 | FIRST CHOICE | $923 | — | $923 | 9.57% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| POLESTAR BENEFITS INC EIN 20-2371430 FSA ADMINISTRATOR | Claims processing; Direct payment from the plan Service code 12 | 412 JEFFERSON PARKWAY STE. 202 LAKE OSWEGO, OR 97035 | $5K |
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 | 409 | 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) | 409 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | GROUP HEALTH COOPERATIVE | 356 | $3.8M |
| Vision(2 contracts, 2 carriers) | GROUP HEALTH COOPERATIVE | 356 | $3.8M |
| Life insurance(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 677 | $265K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 677 | $208K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 677 | $208K |
| Prescription drug(2 contracts, 2 carriers) | GROUP HEALTH COOPERATIVE | 356 | $3.8M |
| Other(4 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 677 | $294K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 677 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.