| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| INTERREMEDY INSURANCE SERVICES3 Filed as: INTERREMEDY INSURANCE SERVICES, LLC | 315 MONTGOMERY ST. STE 900 SAN FRANCISCO, CA 94104 | HCC LIFE INSURANCE COMPANY | — | $140K | $140K | 7.00% |
| CROWN RISK MANAGEMENT, LLC3 Filed as: PROPEL INSRUANCE -TACOMA | 1201 PACIFIC AVE. 1000 TACOMA, WA 98402 | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | — | — | $0 | 0.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| AETNA EIN 06-6033492 PPO PROVIDER | Accounting (including auditing); Insurance services; Claims processing; Product termination fees (surrender charges, etc.) Service code 10 | 600 UNIVERSITY ST STE 92 SEATTLE, WA 98101 | $1.8M |
| BENESYS ADMINISTRATORS EIN 38-2383171 TPA | Recordkeeping and information management (computing, tabulating, data processing, etc.); Accounting (including auditing); Plan Administrator; Copying and duplicating; Claims processing; Participant communication; Other services Service code 10 | 18300 CSCDE AVE S STE 141 TUKWILA, WA 98188 | $1.4M |
| RENALOGIC EIN 22-3857341 CLAIMS MANAGEMENT | Consulting (general) Service code 16 | 22601 N 19TH AVE STE 230 PHOENIX, AZ 85027 | $524K |
| THE URBAN LAW FIRM EIN 75-2986189 LEGAL | Legal Service code 29 | 4270 S DCTUR BLVD STE A-9 LAS VAGAS, NV 89103 | $259K |
| CHRISTENSEN, JAMES & MARTIN EIN 88-0330040 LEGAL | Legal; Direct payment from the plan Service code 29 | 7440 W SAHARA AVENUE LAS VEGAS, NV 89117 | $224K |
| WITHUM EIN 52-2385296 PAYROLL AUDITOR | Accounting (including auditing); Direct payment from the plan Service code 10 | 9725 THIRD AVE NE STE 603 SEATTLE, WA 98115 | $222K |
| INNOVATIVE CARE MANAGEMENT EIN 93-1087669 CLAIMS MANAGEMENT | Other services; Direct payment from the plan; Insurance services Service code 23 | PO BOX 22386 PORTLAND, OR 97269 | $169K |
| SMART SOURCE EIN 30-0830429 PRINTING | Direct payment from the plan; Other services Service code 49 | 1153 CONTESSA WAY NIPOMO, CA 93444 | $159K |
| ELIXIR RX SOLUTIONS, LLC EIN 90-1011712 PPO PROVIDER | Other services; Investment management fees paid indirectly by plan Service code 49 | 2181 E. AURORA RD STE 201 TWINSBURG, OH 44087 | $133K |
| PACIFIC HEALTH COALITION EIN 94-3283661 PPO PROVIDER | Other services Service code 49 | 3000 A STREET, SUITE 300 ANCHORAGE, AK 99503 | $111K |
| EMPLOYEE 01 EXECUTIVE DIRECTOR | Employee (plan) Service code 30 | 3621 NORTH ATLANTIC ST SPOKANE, WA 99205 | $111K |
| PROPEL INSURANCE EIN 91-0830024 CONSULTNAT | Insurance brokerage commissions and fees; Insurance agents and brokers Service code 22 | 601 UNION STREET STE 3400 SEATTLE, WA 98101 | $104K |
| WASHINGTON CAPITAL MANAGEMENT, INC. EIN 91-1042342 INVESTMENT MANAGER | Investment management fees paid directly by plan; Investment management Service code 28 | 1200 SIXTH AVE STE 700 SEATTLE, WA 98101 | $98K |
| FERGUSON WELLMAN CAPITAL MANAGEMENT EIN 93-0646988 INVESTMENT MANAGER | Other fees; Investment management fees paid directly by plan Service code 51 | 888 SW 5TH AVENUE PORTLAND, ME 04101 | $75K |
| VISION SERVICES PLAN EIN 23-7089668 CLAIMS MANAGEMENT | Claims processing; Direct payment from the plan Service code 12 | 4380 S MACADAM AVE 310 PORTLAND, ME 97239 | $69K |
| CAREINGTON INTERNATIONAL CORP EIN 75-2425662 CLAIMS MANAGEMENT | Plan Administrator; Insurance services Service code 14 | 7400 GAYLORD PARKWAY FRISCO, TX 75034 | $61K |
| LOCKTOWN COMPANIES EIN 20-3354970 CONSULTANT | Consulting (general) Service code 16 | 7650 EDNBRUGH WAY STE 100 EDIN, MN 55435 | $60K |
| BERRY & COMPANY CPAS, LTD EIN 88-0400174 PAYROLL AUDITOR | Direct payment from the plan; Accounting (including auditing) Service code 10 | 7030 SMOKE RANCH ROAD LAS VEGAS, NV 89128 | $43K |
| BJORKLUND & MONTPLAISIR CPAS EIN 93-1015766 AUDITOR | Accounting (including auditing) Service code 10 | 10300 SW GREENBURG RD 470 PORTLAND, OR 97223 | $31K |
| ARCHIMEDES, LLC EIN 81-1158028 PPO PROVIDER | Direct payment from the plan; Other services Service code 49 | 278 FRANKLIN RD, STE 245 BRENTWOOD, TN 37027 | $23K |
| WELLS FARGO BANK EIN 94-1347393 CUSTODIAN | Other fees Service code 99 | 999 3RD AVE 12FL SEATTLE, WA 98104 | $17K |
| HEALTH SERCVICES COALITION EIN 88-0492643 PPO PROVIDER | Other services Service code 49 | 6655 W SHARA AVE STE C-20 LAS VEGAS, NV 89146 | $13K |
| MILLIMAN, INC. EIN 91-0675641 ACTUARY | Direct payment from the plan; Actuarial Service code 11 | 1301 5TH AVE STE 3800 SEATTLE, WA 98101 | $7K |
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 | 5,389 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 430 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 5,819 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | HUMANA INSURANCE COMPANY | 382 | $2.4M |
| Life insurance | LIFE MAP ASSURANCE COMPANY | 1,662 | $67K |
| Stop-loss / reinsurancereinsurance | HCC LIFE INSURANCE COMPANY | 5,863 | $2.0M |
| Other | LIFE MAP ASSURANCE COMPANY | 1,662 | $67K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 5,863 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.