No brokers reported on this filing.
| Provider | Services | Address | Compensation |
|---|---|---|---|
| WELFARE & PENSION ADMIN SVC, INC. EIN 91-1363171 NONE | Direct payment from the plan; Claims processing; Accounting (including auditing); Plan Administrator Service code 10 | — | $356K |
| PREMERA BLUE CROSS EIN 91-0499247 NONE | Direct payment from the plan Service code 50 | — | $194K |
| WITHUMSMITH&BROWN, PC EIN 22-2027092 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $50K |
| HEALTHLINX LLC EIN 87-0660214 NONE | Consulting (general); Direct payment from the plan Service code 16 | — | $48K |
| INNOVATIVE CARE MANAGEMENT, INC. EIN 93-1087669 NONE | Direct payment from the plan; Other services; Insurance services Service code 23 | — | $45K |
| WASHINGTON CAPITAL MANAGEMENT, INC. EIN 91-1042342 NONE | Investment management; Investment management fees paid directly by plan Service code 28 | — | $35K |
| INNOVATIVE COST MGMT SERVICES, INC. EIN 77-0119752 NONE | Consulting (general); Direct payment from the plan Service code 16 | — | $35K |
| REID, BALLEW, LEAHY & HOLLAND, LLP NONE | Legal; Direct payment from the plan Service code 29 | 100W HARRISON ST,N TOWER, SUITE 300 SEATTLE, WA 98119 | $30K |
| ZELIS NONE | Direct payment from the plan Service code 50 | 149 NEWBURY STREET, 5TH FLOOR BOSTON, MA 02116 | $26K |
| OPTUMRX NONE | Claims processing; Direct payment from the plan Service code 12 | 2300 MAIN STREET IRVINE, CA 92614 | $22K |
| ANASTASI, MOORE & MARTIN, PLLC EIN 20-8149084 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $14K |
| MARSH & MCLENNAN AGENCY NONE | Insurance services; Direct payment from the plan Service code 23 | 1166 AVENUE OF THE AMERICAS NEW YORK, NY 10036 | $12K |
| CHANGE HEALTHCARE NONE | Other services; Direct payment from the plan Service code 49 | 3055 LEBANON PIKE NASHVILLE, TN 37214 | $9K |
| BANK OF AMERICA NONE | Custodial (other than securities); Direct payment from the plan Service code 18 | 525 SOUTH JACKSON STREET SEATTLE, WA 98104 | $8K |
| ALAFFIA TECHNOLOGY NONE | Direct payment from the plan Service code 50 | 169 MADISON AVENUE NEW YORK, NY 10016 | $8K |
| ROBERT A. BOHRER, PLLC EIN 46-3183400 NONE | Direct payment from the plan; Legal Service code 29 | — | $6K |
| U.S. BANK NATIONAL ASSOCIATION EIN 31-0841368 NONE | Direct payment from the plan; Custodial (other than securities); Custodial (securities) Service code 18 | — | $0 |
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 | 639 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 8 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 647 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | VISION SERVICE PLAN | 640 | $39K |
| Life insurance | LIFEMAP ASSURANCE COMPANY | 652 | $17K |
| Stop-loss / reinsurancereinsurance | SYMETRA LIFE INSURANCE COMPANY | 657 | $899K |
| Other | LIFEMAP ASSURANCE COMPANY | 652 | $17K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 657 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Filing reports zero broker compensation on a plan over 100 participants. Likely direct-write or unreported — worth a knock.