| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WHITEFIELDS UNITED INS. AGCY., INC.3 | 3425 BROADWAY EVERETT, WA 98201 | AETNA LIFE INSURANCE COMPANY | $46K | — | $46K | 4.45% |
| CORRY AGENCY, INC.3 | PO BOX 950 GIG HARBOR, WA 98335 | COLONIAL | $6K | $113 | $6K | 9.62% |
| ALBERS & COMPANY3 Filed as: ALBERS AND COMPANY, INC. | PO BOX 11207 TACOMA, WA 98411 | COLONIAL | $4K | — | $4K | 6.51% |
| WHITFIELDS UNITED INS. AGCY. INC.3 Filed as: WHITFIELDS UNITED INS AGCY., INC. | PO BOX 1127 EVERETT, WA 98206 | COLONIAL | $1K | — | $1K | 2.03% |
| JUDY INEZ BUCHOLTZ3 Filed as: JUDY I. BUCHOLTZ | 12517-217TH AVENUE COURT E BONNEY LAKE, WA 98391 | COLONIAL | $725 | $17 | $742 | 1.23% |
| BRIAN WHITE3 Filed as: BRIAN RODERICK | 3104 MCALLISTER STREET DUPONT, WA 98327 | COLONIAL | $370 | $238 | $608 | 1.01% |
| MJ INSURANCE3 Filed as: RANDY DAHL AND VARIOUS AGENTS | 707 SOUTH GRADY WAY RENTON, WA 98057 | COLONIAL | $92 | — | $92 | 0.15% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH AND MCLENNAN AGENCY, LLC | 2300 RENAISSANCE BOULEVARD KING OF PRUSSIA, PA 19406 | COLONIAL | $15 | — | $15 | 0.02% |
| WHITEFIELDS UNITED INS. AGCY., INC.3 | 6050 TACOMA MALL BOULEVARD SUITE 300 TACOMA, WA 98409 | DELTA DENTAL OF WASHINGTON | $3K | — | $3K | 6.94% |
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 | 121 | 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) | 121 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | AETNA LIFE INSURANCE COMPANY | 129 | $1.0M |
| Dental | DELTA DENTAL OF WASHINGTON | 152 | $44K |
| Life insurance | AETNA LIFE INSURANCE COMPANY | 129 | $1.0M |
| Short-term disability | AETNA LIFE INSURANCE COMPANY | 129 | $1.0M |
| Long-term disability | COLONIAL | 63 | $60K |
| Other(2 contracts, 2 carriers) | AETNA LIFE INSURANCE COMPANY | 156 | $1.0M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 156 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.