| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| RAEL & LETSON3 Filed as: RAEL & LETSON, INC. | 999 THIRD AVE STE 1530 SEATTLE, WA 98104 | LIFEMAP ASSURANCE COMPANY | $13K | — | $13K | 1.95% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| AETNA NONE | Direct payment from the plan; Claims processing Service code 12 | 151 FARMINGTON AVE HARTFORD, CT 06156 | $2.0M |
| DELTA DENTAL EIN 91-0621480 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $588K |
| WELLINGTON MANAGEMENT COMPANY NONE | Investment management fees paid indirectly by plan; Investment management fees paid directly by plan Service code 51 | 2 EMBARCADERO CTR STE 1645 SAN FRANCISCO, CA 94111 | $517K |
| EXPRESS SCRIPTS EIN 43-1420563 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $355K |
| CLISE AGENCY EIN 91-6024838 NONE | Other services; Direct payment from the plan Service code 49 | — | $291K |
| EMPLOYEE 02 EIN 91-6029049 NONE | Employee (plan) Service code 30 | — | $198K |
| BASYS EIN 52-1796473 NONE | Consulting (general); Direct payment from the plan Service code 16 | — | $198K |
| EMPLOYEE 04 EIN 91-6029049 NONE | Employee (plan) Service code 30 | — | $163K |
| EMPLOYEE 03 EIN 91-6029049 NONE | Employee (plan) Service code 30 | — | $162K |
| EMPLOYEE 06 EIN 91-6029049 NONE | Employee (plan) Service code 30 | — | $141K |
| EMPLOYEE 12 EIN 91-6029049 NONE | Employee (plan) Service code 30 | — | $140K |
| EMPLOYEE 05 EIN 91-6029049 NONE | Employee (plan) Service code 30 | — | $139K |
| EMPLOYEE 27 EIN 91-6029049 NONE | Employee (plan) Service code 30 | — | $136K |
| EMPLOYEE 14 EIN 91-6029049 NONE | Employee (plan) Service code 30 | — | $135K |
| CHANGE HEALTHCARE NONE | Direct payment from the plan; Other services; Copying and duplicating Service code 36 | PO BOX 572490 MURRAY, UT 84157 | $134K |
| EMPLOYEE 26 EIN 91-6029049 NONE | Employee (plan) Service code 30 | — | $130K |
| EMPLOYEE 50 EIN 91-6029049 NONE | Employee (plan) Service code 30 | — | $129K |
| NURTUR HEALTH INC. EIN 06-1476380 NONE | Other services; Direct payment from the plan Service code 49 | — | $119K |
| EMPLOYEE 07 EIN 91-6029049 NONE | Employee (plan) Service code 30 | — | $119K |
| EMPLOYEE 42 EIN 91-6029049 NONE | Employee (plan) Service code 30 | — | $115K |
| EMPLOYEE 45 EIN 91-6029049 NONE | Employee (plan) Service code 30 | — | $113K |
| EMPLOYEE 10 EIN 91-6029049 NONE | Employee (plan) Service code 30 | — | $113K |
| EMPLOYEE 11 EIN 91-6029049 NONE | Employee (plan) Service code 30 | — | $113K |
| RAEL & LETSON EIN 94-1701048 NONE | Direct payment from the plan; Consulting (general) Service code 16 | — | $113K |
| HEALTH CARE COST MAINTENANCE NONE | Consulting (general); Direct payment from the plan Service code 16 | 3000 A ST STE 300 ANCHORAGE, AK 99503 | $111K |
| EMPLOYEE 09 EIN 91-6029049 NONE | Employee (plan) Service code 30 | — | $109K |
| EKMAN & THULIN PS EIN 92-1321138 NONE | Legal; Direct payment from the plan Service code 29 | — | $108K |
| EMPLOYEE 49 EIN 91-6029049 NONE | Employee (plan) Service code 30 | — | $107K |
| EMPLOYEE 18 EIN 91-6029049 NONE | Employee (plan) Service code 30 | — | $106K |
| EMPLOYEE 15 EIN 91-6029049 NONE | Employee (plan) Service code 30 | — | $100K |
| EMPLOYEE 40 EIN 91-6029049 NONE | Employee (plan) Service code 30 | — | $97K |
| EMPLOYEE 33 EIN 91-6029049 NONE | Employee (plan) Service code 30 | — | $96K |
| ANASTASI MOORE & MARTIN PLLC EIN 20-8149084 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $95K |
| CHERYL CRAGG NONE | Direct payment from the plan; Copying and duplicating Service code 36 | 14733 NE 57TH ST BELLEVUE, WA 98007 | $94K |
| EMPLOYEE 34 EIN 91-6029049 NONE | Employee (plan) Service code 30 | — | $94K |
| EMPLOYEE 24 EIN 91-6029049 NONE | Employee (plan) Service code 30 | — | $86K |
| EMPLOYEE 43 EIN 91-6029049 NONE | Employee (plan) Service code 30 | — | $83K |
| EMPLOYEE 38 EIN 91-6029049 NONE | Employee (plan) Service code 30 | — | $82K |
| VISION SERVICE PLAN EIN 23-7089668 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $78K |
| EMPLOYEE 36 EIN 91-6029049 NONE | Employee (plan) Service code 30 | — | $75K |
| EMPLOYEE 46 EIN 91-6029049 NONE | Employee (plan) Service code 30 | — | $74K |
| EMPLOYEE 08 EIN 91-6029049 NONE | Employee (plan) Service code 30 | — | $74K |
| EMPLOYEE 39 EIN 91-6029049 NONE | Employee (plan) Service code 30 | — | $73K |
| EMPLOYEE 25 EIN 91-6029049 NONE | Employee (plan) Service code 30 | — | $73K |
| EMPLOYEE 32 EIN 91-6029049 NONE | Employee (plan) Service code 30 | — | $72K |
| EMPLOYEE 17 EIN 91-6029049 NONE | Employee (plan) Service code 30 | — | $70K |
| EMPLOYEE 19 EIN 91-6029049 NONE | Employee (plan) Service code 30 | — | $68K |
| EMPLOYEE 37 EIN 91-6029049 NONE | Employee (plan) Service code 30 | — | $65K |
| EMPLOYEE 28 EIN 91-6029049 NONE | Employee (plan) Service code 30 | — | $65K |
| MCKENZIE ROTHWELL BARLOW & COUGHRAN EIN 91-0889948 NONE | Legal; Direct payment from the plan Service code 29 | — | $64K |
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 | 9,214 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3,494 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Beneficiaries receiving benefits | 0 | Spouses or dependents with eligibility independent of the participant. |
| Total participants (= "Plan participants" tile) | 12,708 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITEDHEALTHCARE OF WASHINGTON INC. | 39 | $227K |
| Life insurance | LIFEMAP ASSURANCE COMPANY | 9,688 | $648K |
| Short-term disability | LIFEMAP ASSURANCE COMPANY | 9,688 | $648K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 9,688 | — |
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.