| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARSH & MCLENNAN AGENCY LLC3 | PO BOX 350 CONSHOHOCKEN, PA 19428 | SYMETRA | $0 | $16K | $16K | 4.63% |
| MARSH & MCLENNAN AGENCY LLC3 | PO BOX 4386 MISSOULA, MT 59806 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $9 | $2K | 8.52% |
| HEARTSEASE LLC3 | 1521 NE 63RD AVE HILLSBORO, OR 97124 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $307 | $1K | 7.76% |
| SCOTT FENTON3 Filed as: SCOTT RONALD FENTON | 1183 MANZANITA DR PACIFICA, CA 94044 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $0 | $845 | $845 | 4.48% |
| WORKSITE BENEFITS GROUP INC3 | 112 NW 114TH ST VANCOUVER, WA 98685 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $189 | $224 | $413 | 2.19% |
| BENEFITS BY DESIGN INC3 | 2101 NE 279TH ST RIDGEFIELD, WA 98642 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $247 | $37 | $284 | 1.51% |
| LUANN E DAVIS3 | 325 N GRANT ST KENNEWICK, WA 99336 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $26 | — | $26 | 0.14% |
| DANIEL SHARP3 | 11622 50TH DR SE EVERETT, WA 98208 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3 | — | $3 | 0.02% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| FIRST CHOICE HEALTH NETWORK, INC. EIN 93-2358498 NONE | Contract Administrator; Claims processing Service code 12 | — | $107K |
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 | 159 | 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) | 159 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF WASHINGTON | 319 | $173K |
| Vision | VISION SERVICE PLAN | 159 | $16K |
| Stop-loss / reinsurancereinsurance | SYMETRA | 156 | $353K |
| Other | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 51 | $19K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 319 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.