| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| INTERREMEDY INSURANCE SERVICES | 315 MONTGOMERY ST, STE 900 SAN FRANCISCO, CA 94104 | HCC LIFE INSURANCE COMPANY | $18K | — | $18K | 5.00% |
| WILLIMETTE DENTAL OF WA | 6120 CAPITAL BLVD S TUMWATER, WA 98501 | WILLAMETTE DENTAL OF WASHINGTON | $20K | — | $20K | 11.50% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| PREMERA EIN 91-0499247 CLAIMS CONSULTANT | Other services; Other fees Service code 49 | PO BOX 327 SEATTLE, WA 98111 | $340K |
| UNITED EMPLOYEES BENEFIT TRUST EIN 91-6061910 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | PO BOX 8130 TACOMA, WA 98418 | $237K |
| INNOVATIVE CARE MANAGEMENT EIN 93-1087669 CLAIMS CONSULTANT | Other services; Other fees Service code 49 | PO BOX 22346 PORTLAND, OR 97269 | $87K |
| PROPEL INSURANCE EIN 91-0830024 CONSULTANT | Consulting fees; Direct payment from the plan; Consulting (general) Service code 16 | 925 FOURTH AVE STE 3200 SEATTLE, WA 98104 | $47K |
| WASHINGTON CAPITAL MANAGEMENT EIN 91-1042342 INVESTMENT MANAGER | Investment management fees paid directly by plan; Investment management Service code 28 | 1301 FIFTH AVENUE STE 1500 SEATTLE, WA 98101 | $34K |
| MCKENZIE ROTHWELL BARLOW & KORPI EIN 91-0889948 ATTORNEY | Legal; Direct payment from the plan Service code 29 | 1325 FOURTH AVE STE 910 SEATTLE, WA 98101 | $27K |
| KEY TRUST COMPANY EIN 91-1382589 CUSTODIAL | Direct payment from the plan; Custodial (securities) Service code 19 | 4900 TIEDMAN ROAD BROOKLYN, OH 44144 | $26K |
| DON A CURTIS & ASSOCIATES PLLC EIN 26-4388619 ACCOUNTANT | Direct payment from the plan; Accounting (including auditing) Service code 10 | PO BOX 7359 COVINGTON, WA 98042 | $16K |
| BJORKLUND & MONTPLAISIR EIN 93-1015766 ACCOUNTANT | Direct payment from the plan; Accounting (including auditing) Service code 10 | 9020 SW WASHINGTON SQAUARE ROAD PORTLAND, OR 97223 | $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 | 1,360 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 1,360 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | WILLAMETTE DENTAL OF WASHINGTON | 427 | $170K |
| Stop-loss / reinsurancereinsurance | HCC LIFE INSURANCE COMPANY | 1,354 | $359K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,354 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.