| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF WASHINGTON INC | — | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON OPTIONS, INC. | $60K | — | $60K | 2.92% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF WASHINGTON INC | — | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON | $14K | — | $14K | 3.20% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF WASHINGTON INC | — | DELTA DENTAL OF WASHINGTON | $9K | — | $9K | 3.97% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF WASHINGTON INC | — | KAISER FOUNDATION HEALTH PLAN, INC. | $8K | — | $8K | 3.60% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF WASHINGTON INC | — | KAISER FOUNDATION HEALTH PLAN, INC. | $8K | — | $8K | 4.26% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF WASHINGTON INC | — | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | $6K | — | $6K | 4.00% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF WASHINGTON INC | — | LIFE INSURANCE COMPANY OF NORTH AMERICA | $12K | — | $12K | 10.00% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF WASHINGTON INC | — | HEALTH PLAN OF NEVADA/SIERRA HEALTH & LIFE | $3K | — | $3K | 4.87% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF WASHINGTON INC | — | LIFE INSURANCE COMPANY OF NORTH AMERICA | $8K | — | $8K | 15.00% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF WASHINGTON INC. | — | AMERITAS LIFE INSURANCE CORP | $2K | — | $2K | 5.00% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF FLORIDA INC. | — | AMERITAS LIFE INSURANCE CORP | — | $1K | $1K | 2.72% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF WASHINGTON, INC. | — | WILLAMETTE DENTAL OF WASHINGTON, INC. | $1K | — | $1K | 4.00% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF WASHINGTON INC | — | LIFE INSURANCE COMPANY OF NORTH AMERICA | $4K | — | $4K | 15.00% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF WASHINGTON INC | — | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $818 | $50 | $868 | 3.95% |
| ZACHAREE KEITH SIAHPUSH3 | — | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $325 | $70 | $395 | 1.80% |
| BRIAN T MURPHY LLC3 | — | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $259 | — | $259 | 1.18% |
| JOEL N NEWMAN AGENCY LLC3 | — | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $134 | — | $134 | 0.61% |
| CARYL ESTES3 | — | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $129 | — | $129 | 0.59% |
| CALEB ANTHONY LAW3 | — | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $88 | — | $88 | 0.40% |
| HR BENEFITS SERVICES, INC.3 Filed as: NW BENEFITS GROUP LLC | — | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $42 | — | $42 | 0.19% |
| LAURABETH CHRISTENSEN3 | — | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $35 | — | $35 | 0.16% |
| LUIS RAFAEL VALLE3 Filed as: LUIS PEREZ BENEFIT INS SOLUTIONS | — | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $31 | — | $31 | 0.14% |
| DOUGLAS-MCCARTY INSURANCE SERVICES3 Filed as: DOUGLAS EDWARD VIESELMEYER | — | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $10 | $13 | $23 | 0.10% |
| MEGAN ELIZABETH CASTO3 | — | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $10 | $6 | $16 | 0.07% |
| WENDY SUE GERSHOW3 | — | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $15 | — | $15 | 0.07% |
| LIFE TIME SOLUTIONS LLC3 Filed as: LIFE TIME SOLUTIONS | — | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $12 | — | $12 | 0.05% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF WASHINGTON INC | — | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | — | $1K | 10.00% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF WASHINGTON INC | — | DENTAL HEALTH SERVICES | $180 | — | $180 | 4.00% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF WASHINGTON INC | — | HARTFORD LIFE AND ACCIDENT | $184 | — | $184 | 15.01% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| NAVIA BENEFIT SOLUTIONS, INC. EIN 91-1467758 FSA ADMINISTRATOR | Claims processing Service code 12 | — | $9K |
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 | 363 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 363 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(6 contracts, 5 carriers) | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON OPTIONS, INC. | 278 | $3.1M |
| Dental(3 contracts, 3 carriers) | DELTA DENTAL OF WASHINGTON | 406 | $271K |
| Vision(6 contracts, 5 carriers) | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON OPTIONS, INC. | 734 | $3.1M |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 460 | $117K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 164 | $26K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 363 | $56K |
| Prescription drug(6 contracts, 5 carriers) | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON OPTIONS, INC. | 278 | $3.1M |
| Other(4 contracts, 3 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 460 | $151K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 734 | — |
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."
No prospect flags tripped on this filing.