| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| INTERREMEDY INSURANCE SERVICES | 315 MONTGOMERY ST. SUITE 900 SAN FRANCISCO, CA 94104 | COMPANION LIFE COLUMBIA, SC | $37K | — | $37K | 5.19% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| AETNA EIN 06-6033492 CLAIMS ADMINISTRATOR | Insurance services; Accounting (including auditing); Claims processing; Product termination fees (surrender charges, etc.); Direct payment from the plan Service code 10 | — | $295K |
| ASSOCIATED THIRD PARTY ADMIN. EIN 94-1668624 THIRD PARTY ADMINISTRATOR | Contract Administrator Service code 13 | 7600 SW MOHAWK STREET TUALATIN, OR 97062 | $70K |
| WASHINGTON CAPITAL MANAGEMENT, INC. EIN 91-1042342 INVESTMENT MANAGER | Investment management fees paid directly by plan Service code 51 | 1301 FIFTH AVE, ST. 3100 SEATTLE, WA 98101 | $29K |
| PROPEL INSURANCE EIN 91-0830024 CONSULTANT | Insurance brokerage commissions and fees; Consulting (general); Insurance agents and brokers Service code 16 | 925 FOURTH AVE, ST. 3200 SEATTLE, WA 98104 | $24K |
| BJORKLUND & MONTPLAISIR EIN 93-1015766 AUDITORS | Accounting (including auditing) Service code 10 | 9020 SW WA SQUARE RD,460 PORTLAND, OR 97223 | $21K |
| MILLIMAN USA EIN 91-0675641 ACTUARY | Actuarial Service code 11 | 1301 FIFTH AVE, ST. 3800 SEATTLE, WA 98101 | $16K |
| US BANK EIN 41-6271370 INVESTMENT CUSTODIAN | Custodial (securities) Service code 19 | 555 SW OAK STREET PORTLAND, OR 97208 | $9K |
| MCKENZIE ROTHWELL BARLOW & COUGHRAN EIN 91-0889948 LEGAL COUNSEL | Legal Service code 29 | 1325 FOURTH AVE, ST. 910 SEATTLE, WA 98101 | $8K |
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 | 412 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 52 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 464 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | AETNA | 513 | $42K |
| Dental | AETNA | 513 | $26K |
| Life insurance | AETNA | 513 | $26K |
| Stop-loss / reinsurancereinsurance | COMPANION LIFE COLUMBIA, SC | 464 | $718K |
| Other | AETNA | 513 | $26K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 513 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.