| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CAPITAL BENEFIT SERVICES, INC.3 Filed as: CAPITAL BENEFIT SERVICES | 15375 SE 30TH PL, STE 380 BELLEVUE, WA 98007 | REGENCE BLUESHIELD | $113K | $0 | $113K | 5.40% |
| CAPITAL BENEFIT SERVICES, INC.3 Filed as: CAPITAL BENEFIT SERVICES | 15375 SE 30TH PL, STE 380 BELLEVUE, WA 98007 | LIFEMAP ASSURANCE COMPANY | $10K | $0 | $10K | 4.46% |
| BRUCE BRENNEN3 | 10885 NE 4TH ST, STE 1400 BELLEVUE, WA 98004 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $8K | $0 | $8K | 7.45% |
| NYLIFE SECURITIES LLC3 | 51 MADISON AVE, ROOM 606 NEW YORK, NY 10010 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $798 | $798 | 0.75% |
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 | 238 | 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) | 240 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | REGENCE BLUESHIELD | 244 | $2.1M |
| Dental | LIFEMAP ASSURANCE COMPANY | 250 | $218K |
| Life insurance | LIFEMAP ASSURANCE COMPANY | 250 | $218K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 265 | $106K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 265 | $106K |
| Other | MAGELLAN BEHAVIORAL HEALTH | 227 | $4K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 265 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
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.