| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN AND BROWN OF WASHINGTON, INC. | 1501 4TH AVENUE, SUITE 2400 SEATTLE, WA 98101 | AETNA LIFE INSURANCE COMPANY | $19K | $82 | $19K | 2.53% |
| FORTUNE MANAGEMENT, INC.3 | PO BOX 75009 SEATTLE, WA 98125 | AETNA LIFE INSURANCE COMPANY | $4K | $0 | $4K | 0.52% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN AND BROWN OF WASHINGTON, INC. | UNKNOWN SEATTLE, WA 98121 | DELTA DENTAL OF WASHINGTON | $1K | $0 | $1K | 3.77% |
| FORTUNE MANAGEMENT, INC.3 | PO BOX 75009 SEATTLE, WA 98125 | DELTA DENTAL OF WASHINGTON | $408 | $0 | $408 | 1.23% |
| SERVCO INSURANCE SERVICES CORP3 Filed as: SERVCO PACIFIC INSURANCE | UNKNOWN SEATTLE, WA 98121 | WILLAMETTE DENTAL OF WASHINGTON, INC. | $593 | $0 | $593 | 3.37% |
| FORTUNE MANAGEMENT, INC.3 | PO BOX 75009 SEATTLE, WA 98125 | WILLAMETTE DENTAL OF WASHINGTON, INC. | $288 | $0 | $288 | 1.64% |
| LIFE AND HEALTH UNDERWRITERS, INC.3 | 601 UNION STREET SEATTLE, WA 98101 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $0 | $1K | 7.40% |
| LAURA MCCLUNG PLYLER3 Filed as: LAURA CRADDOCK | 6820 COAL CREEK PARKWAY SE NEW CASTLE, WA 98059 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $828 | $77 | $905 | 5.58% |
| JOEL N NEWMAN AGENCY LLC3 Filed as: JOEL N. NEWMAN AGENCY, LLC | 12360 LAKE CITY WAY NE SEATTLE, WA 98125 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $544 | $59 | $603 | 3.72% |
| BRIAN T MURPHY LLC3 Filed as: BRIAN T. MURPHY, LLC | 5002 47TH AVENUE SW SEATTLE, WA 98136 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $289 | $61 | $350 | 2.16% |
| STEPHANIE GREGOIRE3 Filed as: STEPHANIE GREGOIRE AND OTHER AGENTS | 2108 SOROYA COURT SW OLYMPIA, WA 98502 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $163 | $11 | $174 | 1.07% |
| SANDRA LEE BERGMAN3 | 1880 25TH AVENUE NE, SUITE 411 ISSAQUAH, WA 98029 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $116 | $0 | $116 | 0.72% |
| LAURABETH CHRISTENSEN3 | 19807 2ND DRIVE SE BOTHELL, WA 98012 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $52 | $30 | $82 | 0.51% |
| SERVCO INSURANCE SERVICES CORP3 Filed as: SERVCO INSURANCE SERVICES WA. | 800 5TH AVENUE, SUITE 2400 SEATTLE, WA 98104 | VISION SERVICE PLAN | $594 | $0 | $594 | 6.63% |
| FORTUNE MANAGEMENT, INC.3 | 10702 39TH AVENUE NE SEATTLE, WA 98125 | VISION SERVICE PLAN | $107 | $0 | $107 | 1.19% |
| SERVCO INSURANCE SERVICES CORP3 Filed as: SERVCO INSURANCE SERVICES WA., LLC | 800 FIFTH AVENUE, SUITE 2400 SEATTLE, WA 98104 | LIFEMAP ASSURANCE COMPANY | $237 | $0 | $237 | 12.55% |
| FORTUNE MANAGEMENT, INC.3 | PO BOX 75009 SEATTLE, WA 98125 | LIFEMAP ASSURANCE COMPANY | $84 | $0 | $84 | 4.45% |
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 | 104 | 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) | 105 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | AETNA LIFE INSURANCE COMPANY | 95 | $760K |
| Dental(2 contracts, 2 carriers) | DELTA DENTAL OF WASHINGTON | 63 | $51K |
| Vision | VISION SERVICE PLAN | 71 | $9K |
| Life insurance(2 contracts, 2 carriers) | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 104 | $18K |
| Short-term disability | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 16 | $16K |
| Prescription drug | AETNA LIFE INSURANCE COMPANY | 95 | $760K |
| Other(2 contracts, 2 carriers) | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 104 | $18K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 104 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.