| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CAPITAL BENEFIT SERVICES, INC.3 | 15375 SE 30TH PLACE SUITE 380 BELLEVUE, WA 98007 | REGENCE BLUE SHIELD | $482K | $11K | $493K | 5.07% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHWEST LLC | 110 UNITY STREET BELLINGHAM, WA 98225 | REGENCE BLUE SHIELD | — | $11K | $11K | 0.11% |
| PSG WASHINGTON INC3 Filed as: PSG WASHINGTON, INC. | 2727 OAKES AVE #201 EVERETT, WA 98201 | REGENCE BLUE SHIELD | — | $6K | $6K | 0.06% |
| MCGREGOR INSURANCE AGENCY, INC.3 Filed as: MCGREGOR INSURANCE AGENCY INC | 83 N MABLE ST MCGREGOR, MN 55760 | REGENCE BLUE SHIELD | — | $2K | $2K | 0.03% |
| DC BENEFITS INC3 | 15355 SE 30TH PL STE 240 BELLEVUE, WA 98007 | REGENCE BLUE SHIELD | — | $2K | $2K | 0.02% |
| J D PHILLIPS & ASSOC. INC3 Filed as: JD PHILLIPS & ASSOCIATES INC | 1292 E AXTON RD BELLINGHAM, WA 98226 | REGENCE BLUE SHIELD | — | $900 | $900 | 0.01% |
| CAPITAL BENEFIT SERVICES, INC.3 | 15375 SE 30TH PLACE SUITE 380 BELLEVUE, WA 98007 | ASURIS NORTHWEST HEALTH | $19K | $1K | $20K | 4.63% |
| CAPITAL BENEFIT SERVICES, INC.3 Filed as: CAPITAL BENEFT SERVICES INC | 15375 SE 39TH PLACE SUITE 380 BELLEVUE, WA 98007 | LIFEMAP ASSURANCE COMPANY | $37K | — | $37K | 10.12% |
| CAPITAL BENEFIT SERVICES, INC.3 Filed as: CAPITAL BENEFIT SERVICES INC | — | GROUP HEALTH OPTIONS, INC. | $11K | — | $11K | 5.41% |
| CAPITAL BENEFIT SERVICES, INC.3 Filed as: CAPITAL BENEFIT SERVICES | 15375 SE 30TH PLACE STE 380 BELLEVUE, WA 98007 | MEGELLAN BEHAVIORAL HEALTH | $1K | — | $1K | 12.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| EPK & ASSOCIATES, INC. NONE | Plan Administrator; Direct payment from the plan Service code 14 | 15375 SE 30TH PL #380 BELLEVUE, WA 98007 | $232K |
| KUTSCHER HEREFORD BERTRAM BURKART NONE | Direct payment from the plan; Insurance services Service code 23 | 705 2ND AVE #800 SEATTLE, WA 98104 | $25K |
| ANASTASI, MOORE & MARTIN, PLLC NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | 9 S. WASHINGTON ST., STE. 600 SPOKANE, WA 99201 | $14K |
| KIBBLE & PRENTICE NONE | Direct payment from the plan; Insurance services Service code 23 | 601 UNION ST., STE. 1000 SEATTLE, WA 98101 | $9K |
| STOLL & TUTTLE, PLLC NONE | Legal; Direct payment from the plan Service code 29 | 2033 SIXTH AVENUE, SUITE 993 SEATTLE, WA 98121 | $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 | 2,836 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 2,836 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 4 carriers) | REGENCE BLUE SHIELD | 2,599 | $10.4M |
| Dental | LIFEMAP ASSURANCE COMPANY | 2,030 | $368K |
| Vision | LIFEMAP ASSURANCE COMPANY | 2,030 | $368K |
| Life insurance | LIFEMAP ASSURANCE COMPANY | 2,030 | $368K |
| Other | MEGELLAN BEHAVIORAL HEALTH | 571 | $9K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,599 | — |
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 compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Multiple-employer welfare arrangement. Specific regulatory and compliance context; specific consultant niche.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.