| 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 | $3K | — | $3K | 0.48% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| AETNA LIFE INSURANCE COMPANY EIN 06-6033492 NONE | Contract Administrator; Direct payment from the plan; Claims processing Service code 12 | — | $2.0M |
| EPLAN LLC NONE | Direct payment from the plan; Other services Service code 49 | 226011 19TH AVE #200 PHOENIX, AZ 85027 | $750K |
| WELLINGTON MANAGEMENT COMPANY EIN 04-2683227 NONE | Direct payment from the plan; Investment management fees paid directly by plan; Investment management fees paid indirectly by plan Service code 50 | — | $551K |
| DELTA DENTAL EIN 91-0621480 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $524K |
| CLISE AGENCY EIN 91-6024838 NONE | Direct payment from the plan; Other services Service code 49 | — | $308K |
| CHERYL CRAGG NONE | Direct payment from the plan; Copying and duplicating Service code 36 | 14733 NE 57TH ST BELLEVUE, WA 98007 | $289K |
| EXPRESS SCRIPTS EIN 22-3461740 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $273K |
| BASYS EIN 52-1796473 NONE | Consulting (general); Direct payment from the plan Service code 16 | — | $254K |
| EMPLOYEE 01 EIN 91-6029049 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $215K |
| EMPLOYEE 02 EIN 91-6029049 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $181K |
| EMPLOYEE 03 EIN 91-6029049 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $176K |
| EMPLOYEE 04 EIN 91-6029049 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $154K |
| ANASTASI MOORE & MARTIN PLLC EIN 20-8149084 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $148K |
| EMPLOYEE 06 EIN 91-6029049 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $147K |
| EMPLOYEE 09 EIN 91-6029049 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $144K |
| EMPLOYEE 13 EIN 91-6029049 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $144K |
| EMPLOYEE 07 EIN 91-6029049 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $141K |
| EMPLOYEE 12 EIN 91-6029049 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $137K |
| EMPLOYEE 16 EIN 91-6029049 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $133K |
| CHANGE HEALTHCARE NONE | Direct payment from the plan; Other services; Copying and duplicating Service code 36 | PO BOX 572490 MURRAY, UT 84157 | $124K |
| EMPLOYEE 14 EIN 91-6029049 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $123K |
| EMPLOYEE 05 EIN 91-6029049 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $123K |
| EMPLOYEE 19 EIN 91-6029049 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $119K |
| EMPLOYEE 35 EIN 91-6029049 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $115K |
| EMPLOYEE 15 EIN 91-6029049 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $113K |
| EMPLOYEE 08 EIN 91-6029049 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $113K |
| EMPLOYEE 18 EIN 91-6029049 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $108K |
| RAEL & LETSON EIN 94-1701048 NONE | Direct payment from the plan; Actuarial; Consulting (general) Service code 11 | — | $107K |
| EMPLOYEE 29 EIN 91-6029049 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $102K |
| EMPLOYEE 34 EIN 91-6029049 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $96K |
| HEALTH CARE COST MAINTENANCE NONE | Direct payment from the plan; Consulting (general) Service code 16 | 3000 A ST STE 300 ANCHORAGE, AK 99503 | $94K |
| EMPLOYEE 30 EIN 91-6029049 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $94K |
| EMPLOYEE 11 EIN 91-6029049 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $93K |
| EMPLOYEE 24 EIN 91-6029049 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $84K |
| VISION SERVICE PLAN EIN 23-7089668 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $84K |
| EMPLOYEE 39 EIN 91-6029049 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $81K |
| LAW OFFICE OF RICHARD A.EKMAN,P.S. EIN 91-1321138 NONE | Legal; Direct payment from the plan Service code 29 | — | $76K |
| EMPLOYEE 31 EIN 91-6029049 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $74K |
| EMPLOYEE 28 EIN 91-6029049 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $73K |
| EMPLOYEE 21 EIN 91-6029049 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $73K |
| EMPLOYEE 26 EIN 91-6029049 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $73K |
| EMPLOYEE 33 EIN 91-6029049 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $73K |
| EMPLOYEE 38 EIN 91-6029049 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $73K |
| EMPLOYEE 36 EIN 91-6029049 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $69K |
| EMPLOYEE 17 EIN 91-6029049 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $69K |
| EMPLOYEE 32 EIN 91-6029049 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $66K |
| EMPLOYEE 27 EIN 91-6029049 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $65K |
| SHARP BUSINESS SYSTEMS EIN 13-1968872 NONE | Direct payment from the plan; Copying and duplicating Service code 36 | — | $62K |
| EMPLOYEE 23 EIN 91-6029049 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $62K |
| EMPLOYEE 20 EIN 91-6029049 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $61K |
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 | 9,500 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1,780 | 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) | 11,280 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITEDHEALTHCARE OF WASHINGTON INC. | 33 | $194K |
| Life insurance | LIFEMAP ASSURANCE COMPANY | 10,183 | $708K |
| Short-term disability | LIFEMAP ASSURANCE COMPANY | 10,183 | $708K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 10,183 | — |
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.