Filings through .
| Carrier | Coverage | Premium, renewal |
|---|---|---|
HealthRxPPO | HealthRxPPO | Pro |
Dental | Dental | Pro |
LifeOther | LifeOther | Pro |
Vision | Vision | Pro |
See premium, retention and renewal dates for 4 contracts with Pro.
Pro shows premium, covered lives, retention, contract numbers and the renewal date for each contract. Free for 7 days, no card. Then $49 a month. Cancel any time.
No brokers reported on this filing.
| Provider | Services | Address | Compensation |
|---|---|---|---|
| VIMLY BENEFIT SOLUTIONS INC EIN 91-1603312 | Other services; Contract Administrator Service code 13 | PO BOX 75449 SEATTLE, WA 98175 | $208 |
| BARNES & THORNBURG LLP EIN 35-0900596 | Legal Service code 29 | 11 SOUTH MERIDIAN ST INDIANAPOLIS, IN 46204 | $5 |
| FORTERRA INC EIN 20-3642694 | Other services Service code 49 | PO BOX 7508 OLYMPIA, WA 98507 | $0 |
| PROPOINT LLC EIN 27-3322664 | Insurance agents and brokers Service code 22 | 525 COLUMBIA ST NW SUITE 204 OLYMPIA, WA 98501 | $0 |
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 | 31 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 31 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | PREMERA BLUE CROSS | 31 | $28K |
| Dental | DELTA DENTAL OF WASHINGTON | 14 | $853 |
| Vision | VISION SERVICE PLAN | 33 | $75 |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 31 | $76 |
| Prescription drug | PREMERA BLUE CROSS | 31 | $28K |
| Other | METROPOLITAN LIFE INSURANCE COMPANY | 31 | $76 |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 33 | — |
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."
The top carrier holds over 85% of premium. A rate increase from that carrier moves the whole plan.
Schedule A changed between filings. The plan moved between insured and self-funded, or contracts were added or removed. The transition window is open.