| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| NORTHWEST MARKETING RESOURCES3 | PO BOX 447 OLYMPIA, WA 98507 | DELTA DENTAL OF WASHINGTON | $90K | — | $90K | 7.00% |
| BELL-ANDERSON AGENCY INC3 Filed as: BELL ANDERSON AGENCY INC | 19401 40TH AVE W STE 440 LYNNWOOD, WA 98036 | PACIFIC SOURCE HEALTH PLANS | $25K | — | $25K | 2.43% |
| NORTHWEST MARKETING RESOURCES3 Filed as: NORTHWEST MARKETING RESOURCES INC | PO BOX 447 OLYMPIA, WA 98507 | PACIFIC SOURCE HEALTH PLANS | $11K | — | $11K | 1.02% |
| PILKEY HOPPING & EKBERG INC3 | 2102 N PEARL ST STE 102 TACOMA, WA 98406 | PACIFIC SOURCE HEALTH PLANS | $6K | — | $6K | 0.62% |
| ANGLER INSURANCE LLC3 | 512 HOLLY LANE SHELTON, WA 98584 | PACIFIC SOURCE HEALTH PLANS | $3K | — | $3K | 0.28% |
| BELL-ANDERSON AGENCY INC3 Filed as: BELL ANDERSON AGENCY INC | 600 SW 39TH ST STE 200 RENTON, WA 98057 | PACIFIC SOURCE HEALTH PLANS | — | $3K | $3K | 0.25% |
| ACRISURE LLC3 Filed as: ACRISURE NORTHWEST PARTNERS INSURAN | PO BOX 1788 GRAND RAPIDS, MI 49501 | PACIFIC SOURCE HEALTH PLANS | $2K | — | $2K | 0.15% |
| HAWKS VIEW3 | 2721 CITRUS RD STE A RANCHO CORDOVA, CA 95742 | PACIFIC SOURCE HEALTH PLANS | $1K | — | $1K | 0.11% |
| PCF INSURANCE SERVICES OF THE WEST3 | PO BOX 1547 MOUNT VERNON, WA 98273 | PACIFIC SOURCE HEALTH PLANS | $956 | — | $956 | 0.09% |
| DURNEY INSURANCE INC3 | 409 8TH ST HOQUIAM, WA 98550 | PACIFIC SOURCE HEALTH PLANS | $887 | — | $887 | 0.09% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| TRUSTEED PLANS SERVICE CORPORATION EIN 91-0780588 NONE | Direct payment from the plan; Contract Administrator Service code 13 | — | $63K |
| JOHN S. CONNIFF PLLC NONE | Legal; Direct payment from the plan Service code 29 | P.O. BOX 7933 253-759-7767 TACOMA, WA 98417 | $36K |
| MILLER KAPLAN ARASE LLP EIN 95-2036255 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $16K |
| NORTHWEST MARKETING RESOURCES EIN 91-1314081 NONE | Consulting (general); Direct payment from the plan Service code 16 | — | $14K |
| LINDLEY & ASSOCIATES NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | 1 LAKE BELLEVUE DR STE 110 BELLEVUE, WA 98005 | $8K |
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 | 2,552 | 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) | 2,552 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | PACIFIC SOURCE HEALTH PLANS | 121 | $1.0M |
| Dental | DELTA DENTAL OF WASHINGTON | 2,578 | $1.3M |
| Vision | VISION SERVICE PLAN | 672 | $0 |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,578 | — |
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.
Multiple-employer welfare arrangement. Specific regulatory and compliance context; specific consultant niche.