| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DIMARTINO ASSOCIATES3 | 1501 FOURTH AVE, SUITE 2400 SEATTLE, WA 98901 | STANDARD INSURANCE COMPANY | $36K | — | $36K | 16.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| WELFARE AND PENSION ADMIN SERVICES EIN 91-1363171 NONE | Plan Administrator; Other services; Claims processing; Accounting (including auditing); Direct payment from the plan; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 10 | — | $171K |
| PREMERA BLUE CROSS EIN 91-0499247 NONE | Contract Administrator; Direct payment from the plan; Recordkeeping and information management (computing, tabulating, data processing, etc.); Claims processing Service code 12 | — | $132K |
| DIMARTINO ASSOCIATES EIN 91-0378940 NONE | Consulting fees; Consulting (general); Insurance services; Employee (plan); Insurance brokerage commissions and fees; Insurance agents and brokers Service code 16 | — | $107K |
| BENEFIT PLANS ADMIN SERVICES INC EIN 16-1503696 NONE | Investment management fees paid directly by plan; Claims processing; Trustee (bank, trust company, or similar financial institution); Recordkeeping and information management (computing, tabulating, data processing, etc.); Sub-transfer agency fees; Custodial (other than securities) Service code 12 | — | $94K |
| INNOVATIVE CARE MANAGEMENT EIN 93-1087669 NONE | Direct payment from the plan; Other services Service code 49 | — | $43K |
| WASHINGTON CAPITAL MANAGEMENT, INC EIN 91-1042342 NONE | Investment management fees paid directly by plan; Investment management Service code 28 | — | $32K |
| SOUTH PERRY ENDOSCOPY NONE | Other services Service code 49 | 907 S PERRY ST STE 260 SPOKANE, WA 99205 | $26K |
| BARLOW COUGHRAN MORALES & JOSEPHSON EIN 91-0889948 NONE | Legal; Direct payment from the plan Service code 29 | — | $25K |
| LABORATORIES NORTHWEST NONE | Other services Service code 49 | 315 MLK WAY TACOMA, WA 98415 | $16K |
| DELTA DENTAL OF WASHINGTON EIN 91-0621480 NONE | Claims processing; Recordkeeping and information management (computing, tabulating, data processing, etc.); Direct payment from the plan; Contract Administrator Service code 12 | — | $15K |
| ANASTASI, MOORE & MARTIN, PLLC EIN 20-8149084 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $14K |
| THE RHIZOME COLLABORATIVE NONE | Direct payment from the plan; Other services Service code 49 | PO BOX 410 GREENBANK, WA 98253 | $10K |
| U.S. BANK, NA EIN 31-0841368 NONE | Custodial (securities); Custodial (other than securities); Direct payment from the plan Service code 18 | — | $10K |
| ZELIS NONE | Other services Service code 49 | 149 NEWBURY STREET BOSTON, MA 02116 | $9K |
| PRINT TIME NONE | Copying and duplicating Service code 36 | 2610 WESTERN AVE SEATTLE, WA 98121 | $9K |
| TRAVELERS INSURANCE NONE | Insurance services Service code 23 | PO BOX 2950 HARTFORD, CT 061042950 | $8K |
| CHANGE HEALTHCARE NONE | Other services; Direct payment from the plan Service code 49 | PO BOX 572490 MURRAY, UT 84157 | $8K |
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 | 330 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 80 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 410 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF WASHINGTON | 335 | $546K |
| Life insurance(2 contracts) | STANDARD INSURANCE COMPANY | 295 | $288K |
| Long-term disability | STANDARD INSURANCE COMPANY | 295 | $222K |
| Stop-loss / reinsurancereinsurance | LIFEWISE ASSURANCE COMPANY | 416 | $417K |
| Other | STANDARD INSURANCE COMPANY | 295 | $222K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 416 | — |
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.