| 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 | $650K | $213K | $863K | 6.62% |
| CAPITAL BENEFIT SERVICES, INC.3 | 15375 SE 30TH PLACE, SUITE 380 BELLEVUE, WA 98007 | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON OPTIONS, INC. | $149K | — | $149K | 7.94% |
| CAPITAL BENEFIT SERVICES, INC.3 | 15375 SE 30TH PLACE, SUITE 380 BELLEVUE, WA 98007 | DELTA DENTAL OF WASHINGTON | $86K | — | $86K | 8.83% |
| CAPITAL BENEFIT SERVICES, INC.3 | 15375 SE 30TH PLACE, SUITE 380 BELLEVUE, WA 98007 | ASURIS NORTHWEST HEALTH | $26K | $1K | $27K | 5.24% |
| CAPITAL BENEFIT SERVICES, INC.3 | 15375 SE 30TH PLACE, SUITE 380 BELLEVUE, WA 98007 | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON | $39K | — | $39K | 8.10% |
| CAPITAL BENEFIT SERVICES, INC.3 | 15375 SE 30TH PLACE, SUITE 380 BELLEVUE, WA 98007 | LIFEMAP ASSURANCE COMPANY | $15K | — | $15K | 10.52% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| EPK & ASSOCIATES EIN 91-1947441 NONE | Plan Administrator; Accounting (including auditing); Direct payment from the plan Service code 10 | — | $357K |
| ANASTASI, MOORE & MARTIN, PLLC EIN 20-8149084 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $13K |
| KHBB LAW PLLC EIN 27-0561605 NONE | Legal; Direct payment from the plan Service code 29 | — | $10K |
| TRAVELERS INDEMNITY COMPANY OF AM NONE | Direct payment from the plan; Insurance services 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 | 3,548 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 72 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 3,620 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 4 carriers) | REGENCE BLUE SHIELD | 1,936 | $15.9M |
| Dental | DELTA DENTAL OF WASHINGTON | 1,676 | $979K |
| Vision(3 contracts, 3 carriers) | REGENCE BLUE SHIELD | 2,731 | $13.7M |
| Life insurance | LIFEMAP ASSURANCE COMPANY | 2,731 | $144K |
| Other | LIFEMAP ASSURANCE COMPANY | 2,731 | $144K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,731 | — |
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.