| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| RAEL & LETSON3 | 999 3RD AVE STE 1530 SEATTLE, WA 98104 | PRINCIPAL LIFE INSURANCE CO. | $2K | $243 | $2K | 7.83% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| NORTHWEST ADMINISTRATORS, INC. EIN 91-0680697 NONE | Accounting (including auditing); Investment management fees paid directly by plan; Contract Administrator; Investment management; Direct payment from the plan Service code 10 | — | $11.0M |
| PREMERA BLUE CROSS NONE | Direct payment from the plan; Claims processing Service code 12 | 7001 220TH STREET SW MOUNTLAKE TERRACE, WA 98043 | $4.5M |
| DELTA DENTAL OF WASHINGTON EIN 91-0621480 NONE | Insurance services; Direct payment from the plan; Claims processing Service code 12 | — | $933K |
| MEDIMPACT HEALTHCARE SYSTEMS, INC. EIN 33-0567651 NONE | Claims processing; Other services; Direct payment from the plan Service code 12 | — | $770K |
| KAISER FOUNDATION HEALTH PLAN OF WA EIN 91-1467158 NONE | Direct payment from the plan; Plan Administrator; Claims processing Service code 12 | — | $717K |
| RAEL & LETSON EIN 94-1701048 NONE | Consulting (general); Actuarial; Direct payment from the plan; Insurance agents and brokers Service code 11 | — | $208K |
| SERVICE PRINTING CO. EIN 91-0830372 NONE | Direct payment from the plan; Copying and duplicating Service code 36 | — | $122K |
| REID, MCCARTHY, BALLEW & LEAHY, LLP EIN 91-0749971 NONE | Legal; Direct payment from the plan Service code 29 | — | $86K |
| WASHINGTON HEALTH ALLIANCE EIN 47-0948895 NONE | Direct payment from the plan; Other fees Service code 50 | — | $74K |
| SEYFARTH SHAW LLP EIN 36-2152202 NONE | Legal; Direct payment from the plan Service code 29 | — | $58K |
| K&H PRINTERS LITHOGRAPHERS EIN 91-0531929 NONE | Copying and duplicating; Direct payment from the plan; Other services Service code 36 | — | $46K |
| WELLS FARGO BANK, N.A. EIN 94-1347393 NONE | Direct payment from the plan; Other services Service code 49 | — | $45K |
| MILLER KAPLAN ARASE LLP EIN 95-2036255 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $44K |
| AUKEMA & ASSOCIATES, INC. EIN 20-2023367 NONE | Direct payment from the plan; Participant communication Service code 38 | — | $34K |
| MEDICAL REVIEW INSTITUTE OF AMERICA EIN 87-0515201 NONE | Consulting (general); Direct payment from the plan Service code 16 | — | $31K |
| ALAN D. BILLER & ASSOCIATES EIN 94-2854958 NONE | Investment advisory (plan); Direct payment from the plan Service code 27 | — | $22K |
| STATE STREET BANK EIN 04-1867445 NONE | Trustee (directed); Custodial (securities); Direct payment from the plan; Float revenue; Other fees Service code 19 | — | $21K |
| CAPITOL CITY PRESS, INC. EIN 91-1068832 NONE | Direct payment from the plan; Other services; Copying and duplicating Service code 36 | — | $18K |
| AMERICAN HEALTH HOLDING, INC. EIN 31-1368946 NONE | Other services; Direct payment from the plan Service code 49 | — | $9K |
| CIGNA EIN 59-1031071 NONE | Float revenue; Claims processing; Direct payment from the plan; Product termination fees (surrender charges, etc.); Participant communication; Other services; Contract Administrator Service code 12 | — | $6K |
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 | 19,589 | 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. |
| Beneficiaries receiving benefits | 0 | Spouses or dependents with eligibility independent of the participant. |
| Total participants (= "Plan participants" tile) | 19,589 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON OPTIONS, INC. | 196 | $87K |
| Life insurance(2 contracts) | PRINCIPAL LIFE INSURANCE CO. | 32,611 | $707K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 32,611 | — |
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.