| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CLG EMPLOYER RESOURCES LLC3 | 209 MAIN AVE S, STE. 100 NORTH BEND, WA 98045 | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON | $325 | — | $325 | 0.01% |
| CLG EMPLOYER RESOURCES LLC3 | 209 MAIN AVE S STE 100 NORTH BEND, WA 98045 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $19K | $0 | $19K | 23.87% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS | 422 WAUPONSEE ST MORRIS, IL 60450 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $5K | $0 | $5K | 5.97% |
| CLG EMPLOYER RESOURCES LLC3 | 209 MAIN AVE S, STE. 100 NORTH BEND, WA 98045 | TRANSAMERICA LIFE INSURANCE COMPANY | $3K | — | $3K | 10.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CLG EMPLOYER RESOURCES EIN 27-4743785 NONE | Direct payment from the plan; Insurance brokerage commissions and fees; Consulting (general); Insurance agents and brokers Service code 16 | — | $491K |
| VIMLY BENEFIT SOLUTIONS EIN 91-1603312 NONE | Contract Administrator; Direct payment from the plan; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 13 | — | $250K |
| TOTAL BENEFIT SOLUTIONS, LLC NONE | Consulting (general); Insurance brokerage commissions and fees; Insurance agents and brokers; Direct payment from the plan Service code 16 | 155 108TH AVE NE SUITE 800 BELLEVUE, WA 98004 | $186K |
| WA HOSPITALITY ASSOCIATION EIN 91-0586362 NONE | Contract Administrator; Direct payment from the plan Service code 13 | — | $67K |
| TELADOC HEALTH EIN 04-3705970 NONE | Other services; Direct payment from the plan Service code 49 | — | $52K |
| COMPSYCH EIN 36-3739783 NONE | Direct payment from the plan; Other services Service code 49 | — | $44K |
| BELL-ANDERSON AGENCY, INC. EIN 91-0756278 NONE | Insurance agents and brokers; Insurance brokerage commissions and fees; Direct payment from the plan Service code 22 | — | $40K |
| ESSENTIAL BENEFITS LLC EIN 45-5125484 NONE | Insurance brokerage commissions and fees; Direct payment from the plan; Insurance agents and brokers Service code 22 | — | $34K |
| ASSURED PARTNERS OF WA, LLC EIN 38-3942963 NONE | Direct payment from the plan; Insurance brokerage commissions and fees; Insurance agents and brokers Service code 22 | — | $29K |
| EKMAN, CUSHING & MAXWELL, P.S. EIN 91-1321138 NONE | Legal; Direct payment from the plan Service code 29 | — | $24K |
| PARKER SMITH & FEEK, INC. NONE | Insurance brokerage commissions and fees; Direct payment from the plan; Insurance agents and brokers Service code 22 | 2233 112TH AVE NE BELLEVUE, WA 980042936 | $24K |
| CLIFTONLARSONALLEN LLP EIN 41-0746749 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $23K |
| USI NW DBA KIBBLE & PRENTICE NONE | Insurance agents and brokers; Insurance brokerage commissions and fees; Direct payment from the plan Service code 22 | 601 UNION ST STE 1000 SEATTLE, WA 98101 | $21K |
| ALLIANT INSURANCE SERVICES INC. NONE | Direct payment from the plan; Insurance brokerage commissions and fees; Insurance agents and brokers Service code 22 | 1420 5TH AVE 1500 SEATTLE, WA 98101 | $20K |
| ARMFIELD HARRISON & THOMAS INC NONE | Insurance agents and brokers; Insurance brokerage commissions and fees; Direct payment from the plan Service code 22 | 600 UNIVERSITY ST. SUITE 1200 SEATTLE, WA 98101 | $18K |
| AARON ZWEIFACH NONE | Insurance agents and brokers; Direct payment from the plan; Insurance brokerage commissions and fees Service code 22 | 23106 100TH AVE W EDMONDS, WA 98020 | $12K |
| J FRANKLAND EMPLOYEE BENEFITS SERV NONE | Direct payment from the plan; Insurance agents and brokers; Insurance brokerage commissions and fees Service code 22 | 601 UNION ST STE 3015 SEATTLE, WA 98101 | $11K |
| MADDOCK & ASSOCIATES, LLC EIN 91-1280409 NONE | Insurance agents and brokers; Insurance brokerage commissions and fees; Direct payment from the plan Service code 22 | — | $8K |
| PAYCHEX INSURANCE AGENCY, INC EIN 16-1528391 NONE | Insurance brokerage commissions and fees; Insurance agents and brokers; Direct payment from the plan Service code 22 | — | $7K |
| BERG BENEFITS, INC NONE | Insurance agents and brokers; Direct payment from the plan; Insurance brokerage commissions and fees Service code 22 | 1804 W UNION AVE STE 201 TACOMA, WA 98405 | $6K |
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 | 3,260 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 13 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 3,273 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(6 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON OPTIONS, INC. | 1,370 | $9.9M |
| Dental(2 contracts, 2 carriers) | AMERITAS LIFE INSURANCE CORPORATION | 3,924 | $843K |
| Vision | AMERITAS LIFE INSURANCE CORPORATION | 3,924 | $819K |
| Life insurance(2 contracts, 2 carriers) | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 1,668 | $104K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 3,924 | — |
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 comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.
Multiple-employer welfare arrangement. Specific regulatory and compliance context; specific consultant niche.