| 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 | $647K | $207K | $854K | 6.26% |
| CAPITAL BENEFIT SERVICES, INC.3 | 15375 SE 30TH PLACE, SUITE 380 BELLEVUE, WA 98007 | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON OPTIONS, INC. | $153K | — | $153K | 7.41% |
| CAPITAL BENEFIT SERVICES, INC.3 | 15375 SE 30TH PLACE, SUITE 380 BELLEVUE, WA 98007 | DELTA DENTAL OF WASHINGTON | $76K | — | $76K | 7.00% |
| CAPITAL BENEFIT SERVICES, INC.3 | 15375 SE 30TH PLACE, SUITE 380 BELLEVUE, WA 98007 | ASURIS NORTHWEST HEALTH | $28K | $1K | $29K | 5.02% |
| CAPITAL BENEFIT SERVICES, INC.3 | 15375 SE 30TH PLACE, SUITE 380 BELLEVUE, WA 98007 | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON | $15K | — | $15K | 7.50% |
| CAPITAL BENEFIT SERVICES, INC.3 | 15375 SE 30TH PLACE, SUITE 380 BELLEVUE, WA 98007 | LIFEMAP ASSURANCE COMPANY | $13K | — | $13K | 9.48% |
| CAPITAL BENEFIT SERVICES, INC.3 | 15375 SE 30TH PLACE, SUITE 380 BELLEVUE, WA 98007 | MAGELLAN HEALTHCARE | $1K | — | $1K | 12.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| EPK & ASSOCIATES NONE | Direct payment from the plan; Accounting (including auditing); Plan Administrator Service code 10 | 15375 SE 30TH PL., STE 380 BELLEVUE, WA 98007 | $325K |
| ANASTASI, MOORE & MARTIN, PLLC EIN 20-8149084 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $14K |
| TRAVELERS INDEMNITY COMPANY OF AM NONE | Insurance services; Direct payment from the plan Service code 23 | 1 TOWER SQUARE HARTFORD, CT 06183 | $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 | 3,349 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 33 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 3,382 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(5 contracts, 5 carriers) | REGENCE BLUE SHIELD | 1,881 | $16.5M |
| Dental | DELTA DENTAL OF WASHINGTON | 1,785 | $1.1M |
| Vision(3 contracts, 3 carriers) | REGENCE BLUE SHIELD | 2,607 | $14.3M |
| Life insurance | LIFEMAP ASSURANCE COMPANY | 2,607 | $137K |
| Other(2 contracts, 2 carriers) | LIFEMAP ASSURANCE COMPANY | 2,607 | $147K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,607 | — |
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.