| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| RICH IN BENEFITS INC3 | 13109 NORTHEAST 123RD STREET KIRKLAND, WA 98034 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $9K | $3K | $12K | 5.21% |
| ANTONIO JOSE ANGELES3 Filed as: ANTONIO MICHAEL JAIME | 24345 252ND AVENUE SOUTHEAST MAPLE VALLEY, WA 98038 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $12K | $0 | $12K | 5.20% |
| DEBORAH S GOLDEN3 Filed as: DEBORAH DENISE VIESELMEYER | 14405 115TH AVENUE COURT EAST PUYALLUP, WA 98374 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $2K | $3K | 1.43% |
| ROBERT WILLIAM PLATTE3 | 15221 227TH AVENUE NE WOODINVILLE, WA 98077 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3K | $71 | $3K | 1.26% |
| MEGAN ELIZABETH CASTO3 | UNKNOWN COLUMBIA, SC 29202 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $821 | $2K | 1.01% |
| DOUGLAS-MCCARTY INSURANCE SERVICES3 Filed as: DOUGLAS EDWARD VIESELMEYER | 14405 115TH AVENUE COURT EAST PUYALLUP, WA 98374 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $311 | $2K | 0.94% |
| MJ INSURANCE3 Filed as: RONALD JONES AND VARIOUS AGENTS | 320 NANCY COURT MOSCOW, ID 83843 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $956 | $102 | $1K | 0.46% |
| CAPITAL BENEFIT SERVICES, INC.3 Filed as: CAPITAL BENEFIT SERVICES | 15375 SOUTHEAST 30TH PLACE SUITE 380 BELLEVUE, WA 98007 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $11K | $0 | $11K | 10.08% |
| PRO BENEFITS OF WASHINGTON LLC3 | 15375 SOUTHEAST 30TH PLACE SUITE 380 BELLEVUE, WA 98007 | LIFEMAP ASSURANCE COMPANY | $374 | $0 | $374 | 0.83% |
| BTG AND ASSOCIATES LLC3 | 345 118TH AVENUE SE, SUITE 210 BELLEVUE, WA 98005 | LIFEMAP ASSURANCE COMPANY | $337 | $0 | $337 | 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 | 262 | 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) | 262 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance(2 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 262 | $159K |
| Short-term disability | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 233 | $228K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 236 | $113K |
| Other(2 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 262 | $159K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 262 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.