| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DIMARTINO ASSOCIATES3 Filed as: DIMARTINO ASSOCIATES, INC. | 1301 5TH AVE STE 3701 SEATTLE, WA 98101 | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON | $43K | — | $43K | 3.28% |
| DIMARTINO ASSOCIATES3 Filed as: DIMARTINO ASSOCIATES, INC. | 1501 FOURTH AVE STE 2400 SEATTLE, WA 98101 | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON | $7K | — | $7K | 4.62% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| REGENCE BLUESHIELD EIN 91-0282080 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.); Participant communication; Float revenue; Copying and duplicating; Claims processing; Accounting (including auditing); Other commissions; Direct payment from the plan; Recordkeeping fees; Contract Administrator Service code 10 | — | $1.1M |
| BENEFIT SOLUTIONS, INC. EIN 91-1603312 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.); Contract Administrator; Direct payment from the plan; Accounting (including auditing); Recordkeeping fees; Participant communication; Copying and duplicating; Account maintenance fees Service code 10 | — | $276K |
| NATIONAL INVESTMENT SERVICES, INC. EIN 80-0169636 NONE | Investment management fees paid directly by plan; Direct payment from the plan; Investment management Service code 28 | — | $91K |
| BENESYS EIN 38-2383171 NONE | Participant communication; Accounting (including auditing); Recordkeeping fees; Copying and duplicating; Direct payment from the plan; Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.); Plan Administrator; Claims processing; Account maintenance fees Service code 10 | 18300 CASCADE AVE S STE 141 TUKWILA, WA 98188 | $60K |
| MCKENZIE ROTHWELL BARLOW & COUGHRAN EIN 91-0889948 NONE | Legal; Direct payment from the plan Service code 29 | — | $50K |
| UNION DATA SYSTEMS EIN 27-1619539 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.); Direct payment from the plan Service code 15 | — | $37K |
| BROWN & BROWN OF WA INC EIN 91-0378940 NONE | Insurance services; Recordkeeping and information management (computing, tabulating, data processing, etc.); Consulting (general); Consulting fees; Direct payment from the plan Service code 15 | — | $34K |
| BNY MELLON ASSET SERVICING EIN 13-5160382 NONE | Custodial (securities); Direct payment from the plan Service code 19 | — | $28K |
| VISION SERVICE PLAN EIN 91-6056925 NONE | Copying and duplicating; Contract Administrator; Direct payment from the plan; Recordkeeping fees; Claims processing; Recordkeeping and information management (computing, tabulating, data processing, etc.); Participant communication; Accounting (including auditing) Service code 10 | — | $27K |
| WELFARE & PENSION ADMINISTRATION SE EIN 91-1363171 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $25K |
| SERVICE PRINTING NONE | Direct payment from the plan; Recordkeeping and information management (computing, tabulating, data processing, etc.); Copying and duplicating; Other services Service code 15 | 3887 13TH AVE W #106 SEATTLE, WA 98119 | $25K |
| GRANDFLOW INC. NONE | Copying and duplicating; Participant communication; Direct payment from the plan; Other services Service code 36 | PO BOX 10217 PLEASANTON, CA 94588 | $23K |
| SCHOEDEL & SCHOEDEL CPAS, PLLC EIN 91-0614823 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $18K |
| WEST COAST BUSINESS GRAPHICS EIN 91-2182455 NONE | Copying and duplicating; Participant communication; Direct payment from the plan Service code 36 | — | $8K |
| MILLIMAN USA EIN 91-0675641 NONE | Direct payment from the plan; Actuarial Service code 11 | — | $6K |
| NEPC, LLC EIN 26-1429809 NONE | Investment advisory (plan); Direct payment from the plan Service code 27 | — | $5K |
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 | 1,614 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 45 | 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) | 1,659 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts) | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON | 331 | $1.5M |
| Dental | WILLAMETTE DENTAL OF WASHINGTON, INC. | 381 | $157K |
| Vision | VISION SERVICE PLAN | 1,631 | $180K |
| Life insurance | LIFEMAP ASSURANCE COMPANY | 0 | $0 |
| Stop-loss / reinsurancereinsurance | THE UNION LABOR LIFE INSURANCE COMPANY | 1,605 | $1.1M |
| Other | LIFEMAP ASSURANCE COMPANY | 0 | $0 |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,631 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.