| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CAPITAL BENEFIT SERVICES, INC.3 Filed as: CAPITAL BENEFIT SERVICES, INC | 15375 SE 30TH PLACE, SUITE 380 BELLEVUE, WA 98007 | REGENCE BLUESHIELD | $369K | $162K | $530K | 7.17% |
| CAPITAL BENEFIT SERVICES, INC.3 Filed as: CAPITAL BENEFIT SERVICES, INC | 15375 SE 30TH PLACE, SUITE 380 BELLEVUE, WA 98007 | DELTA DENTAL OF WASHINGTON | $36K | — | $36K | 6.41% |
| CAPITAL BENEFIT SERVICES, INC.3 Filed as: CAPITAL BENEFIT SERVICES, INC | 15375 SE 30TH PLACE, SUITE 380 BELLEVUE, WA 98007 | ASURIS NORTHWEST HEALTH | $14K | $6K | $20K | 7.34% |
| CAPITAL BENEFIT SERVICES, INC.3 Filed as: CAPITAL BENEFIT SERVICES, INC | 15375 SE 30TH PLACE, SUITE 380 BELLEVUE, WA 98007 | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON OPTIONS, INC | $12K | — | $12K | 7.56% |
| CAPITAL BENEFIT SERVICES, INC.3 Filed as: CAPITAL BENEFIT SERVICES, INC | 15375 SE 30TH PLACE, SUITE 380 BELLEVUE, WA 98007 | LIFEMAP ASSURANCE COMPANY | $12K | — | $12K | 10.23% |
| CAPITAL BENEFIT SERVICES, INC.3 Filed as: CAPITAL BENEFIT SERVICES, INC | 15375 SE 30TH PLACE, SUITE 380 BELLEVUE, WA 98007 | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON | $3K | — | $3K | 8.11% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| EPK & ASSOCIATES, INC EIN 91-1947441 NONE | Accounting (including auditing); Other fees; Recordkeeping and information management (computing, tabulating, data processing, etc.); Plan Administrator; Direct payment from the plan Service code 10 | — | $433K |
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 | 1,523 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 29 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 1,552 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 4 carriers) | REGENCE BLUESHIELD | 1,468 | $7.9M |
| Dental | DELTA DENTAL OF WASHINGTON | 1,069 | $557K |
| Vision(3 contracts, 3 carriers) | REGENCE BLUESHIELD | 1,519 | $7.8M |
| Life insurance | LIFEMAP ASSURANCE COMPANY | 1,519 | $113K |
| Prescription drug(4 contracts, 4 carriers) | REGENCE BLUESHIELD | 1,468 | $7.9M |
| Other | LIFEMAP ASSURANCE COMPANY | 1,519 | $113K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,519 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Multiple-employer welfare arrangement. Specific regulatory and compliance context; specific consultant niche.