| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | 1300 SOUTHWEST 5TH AVE, SUITE 500 PORTLAND, OR 97201 | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | $62K | $1K | $63K | 1.42% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | PO BOX 203383 DALLAS, TX 75320 | STANDARD INSURANCE COMPANY | $152K | — | $152K | 4.10% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | 600 HIGHWAY 169 SOUTH, 12TH FLOOR SAINT LOUIS PARK, MN 55426 | KAISER FOUNDATION HEALTH PLAN, INC. | $30K | — | $30K | 4.21% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | PO BOX 203417 DALLAS, TX 75320 | TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION, INC. | $11K | — | $11K | 1.78% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | 1300 SW 5TH AVENUE, SUITE 500 PORTLAND, OR 97201 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $92K | $9K | $101K | 34.06% |
| BENEFITSTORE INC3 | LOCKBOX NUMBER 893383 RICHARDSON, TX 75081 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $92K | — | $92K | 31.05% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | 1300 SOUTHWEST 5TH AVENUE PORTLAND, OR 97201 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $8K | — | $8K | 10.11% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | 222 SW COLUMBIA STREET, SUITE 1250 PORTLAND, OR 97201 | UNITED DENTAL CARE OF TEXAS, INC. | $2K | — | $2K | 10.00% |
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 | 4,457 | 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) | 4,457 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(5 contracts, 5 carriers) | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | 1,250 | $6.2M |
| Dental(3 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | 869 | $4.5M |
| Vision(3 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | 869 | $5.8M |
| Life insurance | STANDARD INSURANCE COMPANY | 4,457 | $3.7M |
| Long-term disability | STANDARD INSURANCE COMPANY | 4,457 | $3.7M |
| Prescription drug(3 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | 869 | $5.8M |
| Other(2 contracts, 2 carriers) | STANDARD INSURANCE COMPANY | 4,457 | $4.0M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 4,457 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.