| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MADDOCK & ASSOCIATES LLC3 | 1407 WILLOW ROAD EAST SUITE C FIFE, WA 98424 | REGENCE BLUESHIELD | $43K | $5K | $48K | 6.16% |
| MADDOCK & ASSOCIATES LLC3 | 1407 WILLOW ROAD EAST SUITE C FIFE, WA 98424 | PRINCIPAL LIFE INSURANCE COMPANY | $493 | $7K | $7K | 9.49% |
| EDWIN J TEDERS3 Filed as: EDWIN TEDERS | 1345 183RD AVE NE BELLEVUE, WA 98008 | AFLAC | $4K | — | $4K | 8.03% |
| DVG INSURANCE, INC.3 Filed as: DVG INSURANCE | 6512 18TH AVE NW SEATTLE, WA 98117 | AFLAC | $2K | — | $2K | 5.17% |
| JAMEY MILLER INC3 | 12942 139RD AVE E BONNEY LAKE, WA 98391 | AFLAC | $593 | — | $593 | 1.24% |
| COTTER CONSULTING & BENEFITS INC3 Filed as: COTTER CONSUTING & BENEFITS | 13526 160TH AVE NE REDMOND, WA 98052 | AFLAC | $381 | — | $381 | 0.79% |
| CHARLES HUGH MACKAY3 | 2383 S MAIN ST STE B100 AKRON, OH 44319 | AFLAC | $269 | — | $269 | 0.56% |
| ROSICLER GONZALES3 | 11347 NE 112TH ST KIRKLAND, WA 98033 | AFLAC | $228 | — | $228 | 0.48% |
| RICHARD HAWKINS3 Filed as: RICHARD A HAWKINS | 512 HOLLY LN SHELTON, WA 98584 | AFLAC | $206 | — | $206 | 0.43% |
| KIMBERLY FERGUSON3 Filed as: KIMBERLY MOGER | 25 SAGELAND EAST WENATCHEE, WA 98802 | AFLAC | $112 | — | $112 | 0.23% |
| CHARLES H WEISSBERGER3 | 54110 MICHELE LN SELBY TOWNSHIP, MI 48315 | AFLAC | $110 | — | $110 | 0.23% |
| JACOB J MCINTOSH3 | 665 S WOODRUFF AVE STE 250 IDAHO FALLS, OR 83401 | AFLAC | $83 | — | $83 | 0.17% |
| DAVID J MCCLELLAN3 Filed as: DAVID JOHN HANNANT | 14830 NE 167TH ST WOODINVILLE, WA 98072 | AFLAC | $65 | — | $65 | 0.14% |
| KYLE BOLLMEIER3 Filed as: KYLE S BOLLMEIER | 8950 BELLEFONTE RD HENRICO, VA 23229 | AFLAC | $20 | — | $20 | 0.04% |
| CRAIG A HANSEN3 Filed as: CRAIG A HANSON | 6848 RIVERDALE DR SE SUITE C TUMWATER, WA 98501 | AFLAC | $20 | — | $20 | 0.04% |
| RANDY JONES3 Filed as: RANDY A JONES | 26685 SE 9TH WAY SAMMAMISH, WA 98075 | AFLAC | $11 | — | $11 | 0.02% |
| BARRY MCPHERSON INC3 | 3928 IRONBARK WAY MCKINNEY, TX 75071 | AFLAC | $9 | — | $9 | 0.02% |
| HEATHER L TOMSON3 | 63607 NE 9TH STREET RENTON, WA 98056 | AFLAC | $8 | — | $8 | 0.02% |
| JOSHUA PAUL GROUP INC3 Filed as: JOSHUA M HELDEROP | 10509 NE 120TH PL KIRKLAND, WA 98034 | AFLAC | $5 | — | $5 | 0.01% |
| PAUL B ROBEDEAU3 | 9523 BAY CT CARMEL, CA 93929 | AFLAC | $4 | — | $4 | 0.01% |
| SCOTT W BLACKSHEAR3 | 108 ALSACE CT PONTE VEDRA BEACH, FL 32082 | AFLAC | — | $1 | $1 | 0.00% |
| MICHAEL C WALKER3 Filed as: MICHAEL A STACHOWIAK | 321 N CLARK ST STE 615 CHICAGO, IL 60654 | AFLAC | $1 | — | $1 | 0.00% |
| SUWAT ASSAWAMATIYANONT3 | 8171 HAMPTON WOOD DR BOCA RATON, FL 33433 | AFLAC | $1 | — | $1 | 0.00% |
| MEGAN ELIZABETH CASTO3 Filed as: MEGAN J STEVENSON | 33305 1ST WAY S STE B203 FEDERAL WAY, WA 98003 | AFLAC | $1 | — | $1 | 0.00% |
| MITCHELL HECTOR MORALES3 Filed as: MITCHELL PUMPIAN | 225 NE BIRCH ST ISSAQUAH, WA 98027 | AFLAC | $1 | — | $1 | 0.00% |
| BRUNN & COMPANY INC.3 Filed as: BRUNN & COMPANY INC | 19225 NE 202ND ST WOODINVILLE, WA 98077 | AFLAC | — | — | $0 | 0.00% |
| RAYME S TEDERS3 | 1345 183RD AVE NE BELLEVUE, WA 98008 | AFLAC | — | — | $0 | 0.00% |
| MADDOCK & ASSOCIATES LLC3 | 1407 WILLOW ROAD EAST SUITE C FIFE, WA 98424 | HARTFORD LIFE AND ACCIDENT | $1K | — | $1K | 10.08% |
| CONNEXION INSURANCE SOLUTIONS3 | 9725 3RD AVE NE STE 110 SEATTLE, WA 98115 | HARTFORD LIFE AND ACCIDENT | $1K | — | $1K | 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 | 114 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 114 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | REGENCE BLUESHIELD | 85 | $782K |
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 87 | $76K |
| Vision | PRINCIPAL LIFE INSURANCE COMPANY | 87 | $76K |
| Life insurance(3 contracts, 3 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 114 | $138K |
| Short-term disability(2 contracts, 2 carriers) | AFLAC | 114 | $62K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 114 | $14K |
| Other | HARTFORD LIFE AND ACCIDENT | 114 | $14K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 114 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.