Filings through .
History & trajectory Charts need 2 or more years. This plan has 9 years on file. Pro shows premium, premium per covered life, covered lives and carrier and broker share for every year.
See pricingBroker comp is under 1% of premium on a plan over $1M. The plan may have no broker or pay a flat fee. Consultants can pitch it.
Multiple-employer welfare arrangement. It has its own regulatory and compliance rules.
The Schedule A insurance contracts show who carries the risk, for which benefits and for how many people.
Premium, covered lives, retention, contract number and renewal month for each carrier are on Pro.
See premium, retention and renewal dates for 8 contracts with Pro. Pro is free for 7 days and then costs $49 a month.
These benefits are declared on the Form 5500 main form. A ✓ means the benefit also has a Schedule A insurance contract. Without one, plan assets or a Schedule C TPA fund the benefit.
The plan reports several different headcounts depending on which form you read. Each one measures a different slice of the population.
| Active participants | 2,522 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 20 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 2,542 | Active, retired or separated, and beneficiaries. Dependents are not counted. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 4 carriers) | REGENCE BLUESHIELD | 2,398 | $17.0M |
| Dental | DELTA DENTAL OF WASHINGTON | 2,290 | $1.2M |
| Vision | DELTA DENTAL OF WASHINGTON | 2,344 | $164K |
| Life insurance(2 contracts) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 2,604 | $98K |
| Prescription drug(4 contracts, 4 carriers) | REGENCE BLUESHIELD | 2,398 | $17.0M |
| Other | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 2,604 | $75K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,604 | - |
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 instead of this filer's headcount. We show the row, but it does not count the people in this plan.
Brokers paid through Schedule A and service providers paid through Schedule C.
Commissions, fees, broker address and the carrier each broker is paid through are on Pro.
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CAPITAL BENEFIT SERVICES, LLC EIN 91-1619527 HR, COMPLIANCE ASSISTANCE | Other services; Insurance agents and brokers; Direct payment from the plan Service code 22 | — | $1.3M |
| EPK & ASSOCIATES, INC. EIN 91-1947441 PLAN ADMINISTRATOR | Direct payment from the plan; Plan Administrator Service code 14 | — | $473K |
| FIRST CHOICE HEALTH EIN 91-1272766 EMPLOYEE ASSISTANCE | Direct payment from the plan; Other services Service code 49 | — | $40K |
| JOHN S. CONNIFF, PLLC EIN 20-3527112 LAWYER | Legal; Direct payment from the plan Service code 29 | — | $24K |
| SWEENEY CONRAD CPA, LLP EIN 41-2336714 ACCOUNTANT | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $19K |
| L/P INSURANCE SERVICES LLC INSURANCE AGENT | Direct payment from the plan; Insurance agents and brokers Service code 22 | 300 EAST 2ND ST SUITE 1300 RENO, NV 89501 | $6K |
This section shows how the plan is funded and what that means for risk.
Welfare charges, retention and retention rate (the carrier margin on this plan) are on Pro.
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9 filings · 2017 to 2025