| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ARMFIELD HARRISON & THOMAS3 | 600 UNIVERSITY ST STE 1300 SEATTLE, WA 98101 | PREMERA BLUE CROSS | $26K | $3K | $29K | 4.62% |
| WELLS FARGO INSURANCE SERVICES3 Filed as: WELLS FARGO INSURANCE SERVICES USA | PO BOX 203588 DALLAS, TX 753203588 | PREMERA BLUE CROSS | $5K | $922 | $6K | 0.98% |
| EDWIN J TEDERS3 | 17616 NE 15TH PL BELLEVUE, WA 98008 | AFLAC | $3K | $105 | $4K | 7.42% |
| VARIOUS OTHER AGENTS3 | — | AFLAC | $2K | $92 | $2K | 3.73% |
| KANSAS DAWN RAY3 | 1695 WOLF HOLLOW ROAD MANITOU, KY 42436 | AFLAC | $1K | $24 | $1K | 2.94% |
| RAYME S TEDERS3 | 17616 NE 15TH PL BELLEVUE, WA 98008 | AFLAC | $694 | $216 | $910 | 1.90% |
| KAREN M STONE3 | 567 LAKE SCENE DR EDDYVILLE, KY 42038 | AFLAC | $452 | $121 | $573 | 1.20% |
| DAVID J MCCLELLAN3 Filed as: DAVID JOHN HANNANT | 14830 NE 167TH ST WOODINVILLE, WA 98072 | AFLAC | $272 | $43 | $315 | 0.66% |
| JACOB J MCINTOSH3 | 7180 SW FIR LOOP STE 250 TIGARD, OH 97223 | AFLAC | $290 | — | $290 | 0.61% |
| ARMFIELD HARRISON & THOMAS3 Filed as: ARMFIELD HARRISON & THOMAS INC | 600 UNIVERSITY ST STE 1300 SEATTLE, WA 981014102 | UNITED OF OMAHA INSURANCE COMPANY | $809 | — | $809 | 16.70% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INS SVCS NORTHWEST INC | 601 UNION ST STE 1300 SEATTLE, WA 981011363 | UNITED OF OMAHA INSURANCE COMPANY | $160 | — | $160 | 3.30% |
| ARMFIELD HARRISON & THOMAS3 Filed as: ARMFIELD HARRISON & THOMAS INC | 600 UNIVERSITY ST STE 1300 SEATTLE, WA 981014102 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $672 | — | $672 | 16.70% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INS SVCS NORTHWEST INC | 601 UNION ST STE 1300 SEATTLE, WA 981011363 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $133 | — | $133 | 3.30% |
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 | 108 | 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) | 109 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | PREMERA BLUE CROSS | 137 | $636K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 19 | $4K |
| Short-term disability | AFLAC | 71 | $48K |
| Long-term disability | UNITED OF OMAHA INSURANCE COMPANY | 19 | $5K |
| Prescription drug | PREMERA BLUE CROSS | 137 | $636K |
| Other(2 contracts, 2 carriers) | AFLAC | 71 | $52K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 137 | — |
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.