| 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 | $532K | $7K | $539K | 5.32% |
| CAPITAL BENEFIT SERVICES, INC.3 Filed as: CAPITAL BENEFIT SERVICES, INC | — | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON OPTIONS, INC | $147K | — | $147K | 5.69% |
| CAPITAL BENEFIT SERVICES, INC.3 Filed as: CAPITAL BENEFIT SERVICES | 15375 SE 30TH PLACE SUITE 380 BELLEVUE, WA 98007 | DELTA DENTAL OF WASHINGTON | $58K | — | $58K | 6.30% |
| CAPITAL BENEFIT SERVICES, INC.3 | 15375 SE 30TH PLACE SUITE 380 BELLEVUE, WA 98007 | ASURIS NORTHWEST HEALTH | $21K | $263 | $22K | 4.83% |
| CAPITAL BENEFIT SERVICES, INC.3 Filed as: CAPITAL BENEFT SERVICES INC | 15375 SE 30TH PLACE SUITE 380 BELLEVUE, WA 98007 | LIFEMAP ASSURANCE COMPANY | $11K | — | $11K | 9.18% |
| CAPITAL BENEFIT SERVICES, INC.3 Filed as: CAPITAL BENEFIT SERVICES | 15375 SE 30TH PLACE STE 380 BELLEVUE, WA 98007 | MEGELLAN HEALTHCARE | $1K | — | $1K | 12.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| EPK & ASSOCIATES, INC. NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.); Direct payment from the plan; Contract Administrator Service code 13 | 15375 SE 30TH PL #380 BELLEVUE, WA 98007 | $303K |
| 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 | Insurance services; Direct payment from the plan Service code 23 | 601 UNION ST., SUITE 1000 SEATTLE, WA 98101 | $7K |
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 | 3,406 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 3,406 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 4 carriers) | REGENCE BLUE SHIELD | 1,829 | $13.2M |
| Dental(2 contracts, 2 carriers) | DELTA DENTAL OF WASHINGTON | 2,402 | $1.0M |
| Vision | LIFEMAP ASSURANCE COMPANY | 2,402 | $123K |
| Life insurance | LIFEMAP ASSURANCE COMPANY | 2,402 | $123K |
| Other | LIFEMAP ASSURANCE COMPANY | 2,402 | $123K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,402 | — |
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.
Multiple-employer welfare arrangement. Specific regulatory and compliance context; specific consultant niche.