| 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 | SUN LIFE ASSURANCE COMPANY OF CANADA | — | $215K | $215K | 7.11% |
| PROPEL INSURANCE3 Filed as: PROPEL INSURANCE - TACOMA | 1201 PACIFIC AVE. #1000 TACOMA, WA 98402 | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | — | $644 | $644 | 0.14% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| AETNA EIN 06-6033492 NONE | Insurance services; Claims processing; Product termination fees (surrender charges, etc.); Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $1.9M |
| BENESYS ADMINISTRATORS EIN 38-2383171 NONE | Claims processing; Copying and duplicating; Recordkeeping and information management (computing, tabulating, data processing, etc.); Direct payment from the plan; Plan Administrator; Participant communication; Other services; Accounting (including auditing) Service code 10 | — | $1.7M |
| RENALOGIC EIN 22-3857341 NONE | Consulting (general); Direct payment from the plan Service code 16 | — | $556K |
| ARCHIMEDES, LLC EIN 81-1158028 NONE | Direct payment from the plan; Other services Service code 49 | — | $306K |
| THE URBAN LAW FIRM EIN 75-2986189 NONE | Legal; Direct payment from the plan Service code 29 | — | $279K |
| CHRISTENSEN JAMES AND MARTIN EIN 88-0330040 NONE | Legal; Direct payment from the plan Service code 29 | — | $175K |
| PACIFIC HEALTH COALITION EIN 94-3283661 NONE | Other services; Direct payment from the plan Service code 49 | — | $175K |
| WITHUM SMITH BROWN EIN 52-2385296 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $161K |
| PROPEL INSURANCE EIN 91-0830024 NONE | Direct payment from the plan; Insurance brokerage commissions and fees; Insurance agents and brokers Service code 22 | — | $127K |
| SMART SOURCE LLC EIN 30-3830429 NONE | Direct payment from the plan; Other services Service code 49 | — | $125K |
| WASHINGTON CAPITAL MANAGEMENT EIN 91-1042342 NONE | Investment management fees paid directly by plan; Investment management; Direct payment from the plan Service code 28 | — | $117K |
| INNOVATIVE CARE MANAGEMENT EIN 93-1087669 NONE | Other services; Insurance services; Direct payment from the plan Service code 23 | — | $87K |
| CANOPY WELLBEING EIN 93-0774210 NONE | Direct payment from the plan Service code 50 | — | $83K |
| FERGUSON WELLMAN CAPITAL MANAGEMENT EIN 93-0646988 NONE | Investment management fees paid directly by plan; Direct payment from the plan; Other fees Service code 50 | — | $70K |
| VISION SERVICE PLAN EIN 23-7089668 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $70K |
| BERRY AND CO. CPA'S EIN 88-0400174 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $66K |
| CAREINGTON INTERNATIONAL CORP EIN 75-2425662 NONE | Insurance services; Plan Administrator Service code 14 | — | $64K |
| RUBIN BROWN LLP NONE | Direct payment from the plan Service code 50 | 7676 FORSYTH BLVD, SUITE 2100 SAINT LEWIS, MO 63105 | $53K |
| LOCKTON EIN 20-3354970 NONE | Consulting (general); Direct payment from the plan Service code 16 | — | $41K |
| MILLIMAN EIN 91-0675641 NONE | Actuarial; Direct payment from the plan Service code 11 | — | $21K |
| PLATFORM CPA'S LLP EIN 88-4342576 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $21K |
| HOLLYWOOD IMPRESS PRINTING NONE | Direct payment from the plan Service code 50 | 5509 NE 122ND AVE 420 PORTLAND, OR 97230 | $20K |
| HEALTH SERVICES COALITION EIN 88-0492643 NONE | Direct payment from the plan Service code 50 | — | $20K |
| US BANK EIN 31-0841368 NONE | Direct payment from the plan Service code 50 | — | $13K |
| ELLIOTT FAMILY ENTERPRISES EIN 13-4342386 NONE | Direct payment from the plan; Other fees Service code 50 | — | $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 | 5,406 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 291 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 5,697 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | HUMANA INSURANCE COMPANY | 374 | $2.0M |
| Life insurance | LIFE MAP ASSURANCE COMPANY | 1,551 | $73K |
| Stop-loss / reinsurancereinsurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 5,438 | $3.0M |
| Other | LIFE MAP ASSURANCE COMPANY | 1,551 | $73K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 5,438 | — |
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 primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.