| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CASCADE VALLEY INSURANCE, INC.3 Filed as: CASCADE VALLEY INSURANCE | 2727 HOLLYCROFT STREET, SUITE 390 GIG HARBOR, WA 98335 | PREMERA BLUE CROSS | $31K | $0 | $31K | 4.00% |
| CASCADE VALLEY INSURANCE, INC.3 Filed as: CASCADE VALLEY INSURANCE INC | PO BOX 1279 GIG HARBOR, WA 98335 | DELTA DENTAL OF WASHINGTON | $3K | $0 | $3K | 4.92% |
| CASCADE VALLEY INSURANCE, INC.3 Filed as: CASCADE VALLEY INSURANCE INC | PO BOX 1279 GIG HARBOR, WA 98335 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $4K | $0 | $4K | 13.98% |
| CASCADE VALLEY INSURANCE, INC.3 Filed as: CASCADE VALLEY INSURANCE INC | PO BOX 1279 GIG HARBOR, WA 98335 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $859 | $0 | $859 | 10.00% |
| CASCADE VALLEY INSURANCE, INC.3 Filed as: CASCADE VALLEY INSURANCE INC | PO BOX 1279 GIG HARBOR, WA 98335 | VISION SERVICE PLAN | $623 | $0 | $623 | 7.79% |
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 | 120 | 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) | 120 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | PREMERA BLUE CROSS | 64 | $764K |
| Dental | DELTA DENTAL OF WASHINGTON | 118 | $68K |
| Vision | VISION SERVICE PLAN | 83 | $8K |
| Life insurance | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 120 | $32K |
| Short-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 112 | $9K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 120 | $32K |
| Prescription drug | PREMERA BLUE CROSS | 64 | $764K |
| Other(2 contracts, 2 carriers) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 132 | $35K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 132 | — |
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.