| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BTG AND ASSOCIATES LLC3 Filed as: BTG AND ASSOCIATES, LLC | 345 118TH AVENUE SE, SUITE 210 BELLEVUE, WA 98005 | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON OPTIONS, INC. | $54K | $0 | $54K | 4.88% |
| BTG AND ASSOCIATES LLC3 Filed as: BTG AND ASSOCIATES, LLC | 345 118TH AVENUE SE, SUITE 210 BELLEVUE, WA 98005 | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON | $9K | $0 | $9K | 5.00% |
| CAPITAL BENEFIT SERVICES, INC.3 Filed as: CAPITAL BENEFIT GROUP, LLC | 15375 SE 30TH PLACE, SUITE 380 BELLEVUE, WA 98007 | DELTA DENTAL OF WASHINGTON | $2K | $0 | $2K | 1.51% |
| BTG AND ASSOCIATES LLC3 Filed as: BTG AND ASSOCIATES, LLC | 345 118TH AVENUE SE, SUITE 210 BELLEVUE, WA 98005 | DELTA DENTAL OF WASHINGTON | $592 | $0 | $592 | 0.49% |
| CAPITAL BENEFIT SERVICES, INC.3 Filed as: CAPITAL BENEFITS SERVICES, INC. | 15375 SE 30TH PLACE, SUITE 380 BELLEVUE, WA 98007 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $3K | $0 | $3K | 11.49% |
| BTG AND ASSOCIATES LLC3 Filed as: BTG AND ASSOCIATES, LLC | 345 118TH AVENUE SE, SUITE 210 BELLEVUE, WA 98005 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $671 | $0 | $671 | 2.32% |
| CAPITAL BENEFIT SERVICES, INC.3 Filed as: CAPITAL BENEFIT GROUP, LLC | 15375 SE 30TH PLACE, SUITE 380 BELLEVUE, WA 98007 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $348 | $0 | $348 | 1.20% |
| CAPITAL BENEFIT SERVICES, INC.3 Filed as: CAPITAL BENEFIT GROUP, LLC | 15375 SE 30TH PLACE, SUITE 380 BELLEVUE, WA 98007 | VISION SERVICE PLAN | $787 | $0 | $787 | 6.15% |
| BTG AND ASSOCIATES LLC3 Filed as: BTG BENEFITS | 345 118TH AVENUE SE, SUITE 210 BELLEVUE, WA 98005 | VISION SERVICE PLAN | $102 | $0 | $102 | 0.80% |
| CAPITAL BENEFIT SERVICES, INC.3 | 15375 SE 30TH PLACE, SUITE 350 BELLEVUE, WA 98007 | VISION SERVICE PLAN | $101 | $0 | $101 | 0.79% |
No Schedule C service providers reported on this filing.
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 | 169 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 169 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON OPTIONS, INC. | 182 | $1.3M |
| Dental | DELTA DENTAL OF WASHINGTON | 228 | $121K |
| Vision | VISION SERVICE PLAN | 148 | $13K |
| Life insurance | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 169 | $29K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 169 | $29K |
| Prescription drug(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON OPTIONS, INC. | 182 | $1.3M |
| Other | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 169 | $29K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 228 | — |
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."
No prospect flags tripped on this filing.