| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MADDOCK & ASSOCIATES LLC3 | 1407 WILLOW ROAD EAST SUITE C FIFE, WA 98424 | REGENCE BLUESHIELD | $65K | — | $65K | 3.77% |
| MADDOCK & ASSOCIATES LLC3 | 1407 WILLOW ROAD EAST SUITE C FIFE, WA 98424 | PRINCIPAL FINANCIAL | $10K | $3K | $13K | 7.96% |
| EDWIN J TEDERS3 Filed as: EDWIN TEDERS | 1345 183RD AVE NE BELLEVUE, WA 98008 | AFLAC | $9K | $486 | $9K | 15.19% |
| BRUNN & COMPANY INC.3 Filed as: BRUNN & COMPANY INC | 19225 NE 202ND ST WOODINVILLE, WA 98077 | AFLAC | $2K | $113 | $2K | 3.55% |
| KIMBERLY FERGUSON3 Filed as: KIMBERLY MOGER | 25 SAGELAND EAST WENATCHEE, WA 98802 | AFLAC | $760 | $0 | $760 | 1.23% |
| JAMEY MILLER INC3 | 12942 193RD AVE E BONNEY LAKE, WA 98391 | AFLAC | $527 | $113 | $640 | 1.04% |
| ROSICLER GONZALES3 | 11550 MIDNIGHT MELODY AVE LAS VEGAS, NV 89138 | AFLAC | $262 | $0 | $262 | 0.42% |
| DVG INSURANCE, INC.3 Filed as: DVG INSURANCE INC | 6512 18TH AVE NW SEATTLE, WA 98117 | AFLAC | $238 | — | $238 | 0.39% |
| COTTER CONSULTING & BENEFITS INC3 | 13526 160TH AVE NE REDMOND, WA 98052 | AFLAC | $227 | — | $227 | 0.37% |
| RICHARD HAWKINS3 | 512 HOLLY LN SHELTON, WA 98584 | AFLAC | $216 | — | $216 | 0.35% |
| CHARLES HUGH MACKAY3 Filed as: CHARLES MACKAY | 2383 S MAIN ST STE B100 AKRON, OH 44319 | AFLAC | $141 | — | $141 | 0.23% |
| JACOB J MCINTOSH3 Filed as: JACOB MCINTOSH | 139 N 3706 E STE 250 RIGBY, OR 83442 | AFLAC | $68 | — | $68 | 0.11% |
| CHARLES D. BLOCK3 Filed as: CHARLES WEISSBERGER | 54110 MICHELE LN SHELBY TOWNSHIP, MI 48315 | AFLAC | $57 | — | $57 | 0.09% |
| DAVID J MCCLELLAN3 Filed as: DAVID HANNANT | 14830 NE 167TH ST WOODINVILLE, WA 98072 | AFLAC | $57 | — | $57 | 0.09% |
| KYLE BOLLMEIER3 | 8950 BELLEFONTE RD HENRICO, VA 23229 | AFLAC | $22 | — | $22 | 0.04% |
| CRAIG WAYNE SOTTILE3 Filed as: CRAIG HANSEN | 6848 RIVERDALE DR SE TUMWATER, WA 98501 | AFLAC | $19 | — | $19 | 0.03% |
| RANDY JONES3 | 26685 SE 9TH WAY SAMMAMISH, WA 98075 | AFLAC | $11 | — | $11 | 0.02% |
| RAYME S TEDERS3 Filed as: RAYME TEDERS | 1345 183RD AVE NE BELLEVUE, WA 98008 | AFLAC | $9 | — | $9 | 0.01% |
| HEATHER TOMSON3 | 26906 140TH AVE SE KENT, WA 98042 | AFLAC | $9 | — | $9 | 0.01% |
| BARRY MCPHERSON INC3 | 3928 IRONBARK WAY MCKINNEY, TX 75071 | AFLAC | $9 | — | $9 | 0.01% |
| PAUL GLOBAL BENEFITS INC3 Filed as: PAUL ROBEDEAU | 9523 BAY CT CARMEL, CA 93923 | AFLAC | $4 | — | $4 | 0.01% |
| JOSHUA HELDEROP3 | 22109 VILLA DR SNOHOMISH, WA 98296 | AFLAC | $4 | — | $4 | 0.01% |
| MITCHELL HECTOR MORALES3 Filed as: MITCHELL PUMPIAN | 225 NE BIRCH ST ISSAQUAH, WA 98027 | AFLAC | $1 | — | $1 | 0.00% |
| MEGAN ELIZABETH CASTO3 Filed as: MEGAN STEVENSON | 33305 1ST WAY S STE B203 FEDERAL WAY, WA 98003 | AFLAC | $1 | — | $1 | 0.00% |
| MICHAEL C WALKER3 Filed as: MICHAEL STACHOWIAK | 321 N CLARK ST STE 615 CHICAGO, IL 60654 | AFLAC | $1 | — | $1 | 0.00% |
| SUWAT ASSAWAMATIYANONT3 | 7294 PANACHE WAY BOCA RATON, FL 33433 | AFLAC | $1 | — | $1 | 0.00% |
| G SCOTT COOKE3 Filed as: SCOTT BLACKSHEAR | 108 ALSACE CT PONTE VEDRA BEACH, FL 32082 | AFLAC | $1 | — | $1 | 0.00% |
| MADDOCK & ASSOCIATES LLC3 | 1407 WILLOW ROAD EAST SUITE C FIFE, WA 98424 | HARTFORD LIFE AND ACCIDENT | — | $2K | $2K | 8.23% |
| CONNEXION INSURANCE SOLUTIONS3 | 9725 3RD AVE NE STE 110 SEATTLE, WA 98115 | HARTFORD LIFE AND ACCIDENT | — | $2K | $2K | 7.00% |
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 | 260 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 260 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | REGENCE BLUESHIELD | 189 | $1.7M |
| Dental | PRINCIPAL FINANCIAL | 185 | $160K |
| Vision | PRINCIPAL FINANCIAL | 185 | $160K |
| Life insurance(3 contracts, 3 carriers) | PRINCIPAL FINANCIAL | 260 | $251K |
| Short-term disability | AFLAC | 47 | $62K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 260 | $29K |
| Other(2 contracts, 2 carriers) | AFLAC | 260 | $91K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 260 | — |
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.