| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| FORTUNE MANAGEMENT, INC.3 | 155 NW 100TH STREET, SUITE B309 SEATTLE, WA 98125 | REGENCE BLUESHIELD | $25K | $3K | $28K | 3.66% |
| FORTUNE MANAGEMENT, INC.3 | PO BOX 75009 SEATTLE, WA 98125 | DELTA DENTAL OF WASHINGTON | $2K | $0 | $2K | 4.63% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NORTHWEST | 601 UNION STREET, SUITE 1000 SEATTLE, WA 98101 | DELTA DENTAL OF WASHINGTON | $467 | $0 | $467 | 1.20% |
| FORTUNE MANAGEMENT, INC.3 | UNKNOWN SEATTLE, WA 98121 | WILLAMETTE DENTAL OF WASHINGTON, INC. | $527 | $0 | $527 | 3.67% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NORTHWEST | 601 UNION STREET, SUITE 1000 SEATTLE, WA 98101 | WILLAMETTE DENTAL OF WASHINGTON, INC. | $191 | $0 | $191 | 1.33% |
| LIFE AND HEALTH UNDERWRITERS, INC.3 Filed as: LIFE & HEALTH UNDERWRITERS, INC. | 601 UNION STREET SEATTLE, WA 98101 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $432 | $0 | $432 | 3.71% |
| JOEL N NEWMAN AGENCY LLC3 Filed as: JOEL N. NEWMAN AGENCY, LLC | 924-B NW 52ND STREET SEATTLE, WA 98107 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $272 | $0 | $272 | 2.34% |
| BRIAN T MURPHY LLC3 Filed as: BRIAN T. MURPHY, LLC | 5002 47TH AVENUE SW SEATTLE, WA 98136 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $118 | $0 | $118 | 1.01% |
| THE MURRAY GROUP3 Filed as: THE MURRAY GROUP, INC. | 2014 NORTH GRADY LANE SPOKANE VALLEY, WA 99016 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $9 | $0 | $9 | 0.08% |
| LAURABETH CHRISTENSEN3 | 16915 SE 272ND STREET KENT, WA 98042 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $6 | $0 | $6 | 0.05% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62949 VIRGINIA BEACH, VA 23466 | VISION SERVICE PLAN | $113 | $0 | $113 | 1.20% |
| FORTUNE MANAGEMENT, INC.3 | 155 NE 100TH STREET, SUITE B309 SEATTLE, WA 98125 | LIFEMAP ASSURANCE COMPANY | $305 | $0 | $305 | 16.50% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NORTHWEST | 601 UNION STREET, SUITE 1000 SEATTLE, WA 98101 | LIFEMAP ASSURANCE COMPANY | $62 | $0 | $62 | 3.35% |
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 | 107 | 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) | 109 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | REGENCE BLUESHIELD | 104 | $756K |
| Dental(2 contracts, 2 carriers) | DELTA DENTAL OF WASHINGTON | 73 | $53K |
| Vision | VISION SERVICE PLAN | 74 | $9K |
| Life insurance(2 contracts, 2 carriers) | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 107 | $13K |
| Short-term disability | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 12 | $12K |
| Prescription drug | REGENCE BLUESHIELD | 104 | $756K |
| Other(2 contracts, 2 carriers) | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 107 | $13K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 107 | — |
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.