| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| INTERREMEDY INSURANCE SERVICES | 315 MONTGOMERY STREET ST 900 SAN FRANCISCO, CA 94104 | THE UNION LABOR LIFE INSURANCE COMPANY | $48K | — | $48K | 5.00% |
| WILLIMETTE DENTAL OF WA Filed as: WILLIMETTE DENTAL OF WASHINGTON | 6120 CAPITAL BLVD S TUMWATER, WA 98501 | WILLIAMETTE DENTAL OF WASHINGTON | — | — | $0 | 0.00% |
| VISION SOURCE PLAN | 3333 QUALITY DRIVE RANCHO CORDOVA, CA 95707 | VISION SOURCE PLAN | — | — | $0 | 0.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| PREMERA EIN 91-0499247 CLAIMS CONSULTANT | Other services; Other fees Service code 49 | PO BOX 327 SEATTLE, WA 98111 | $547K |
| UNITED EMPLOYEES BENEFIT TRUST EIN 91-6061910 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | PO BOX 8130 TACOMA, WA 98418 | $340K |
| INNOVATIVE CARE MANAGEMENT EIN 93-1087669 CLAIMS CONSULTANT | Other services; Other fees Service code 49 | PO BOX 22346 PORTLAND, OR 97269 | $146K |
| WASHINGTON CAPITAL MGMT EIN 91-1042342 INV MANAGER | Investment management; Investment management fees paid directly by plan Service code 28 | 1301 FIFTH AVENUE STE 1500 SEATTLE, WA 98101 | $99K |
| PROPEL INSURANCE EIN 91-0830024 CONSULTANT | Direct payment from the plan; Consulting (general); Consulting fees Service code 16 | 925 FOURTH AVENUE STE 3200 SEATTLE, WA 98104 | $66K |
| KEY BANK EIN 91-1382589 CUSTODIAL | Custodial (securities); Direct payment from the plan Service code 19 | 4900 TIEDMAN ROAD BROOKLYN, OH 44144 | $40K |
| PSG CONSULTING LLC EIN 27-2345574 CLAIMS CONSULTANT | Other services; Other fees Service code 49 | 5360 LEGACY DRIVE BLDG 3 STE 230 PLANO, TX 75024 | $30K |
| BARLOW COUHRAN MORALES & JOSEPHSON EIN 92-0089852 ATTORNEY | Legal; Direct payment from the plan Service code 29 | 1325 FOURTH AVENUE STE 910 SEATTLE, WA 98101 | $28K |
| DON A CURTIS & ASSOCIATES EIN 26-4388619 ACCOUNTANT | Accounting (including auditing); Direct payment from the plan Service code 10 | PO BOX 7359 CONVINGTON, WA 98042 | $18K |
| BJORKLUND & MONTPLAISIR EIN 93-1015766 ACCOUNTANT | Accounting (including auditing); Direct payment from the plan Service code 10 | 9020 SW WASHINGTON SQUARE ROAD PORTLAND, OR 97223 | $15K |
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 | 2,056 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 2,056 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | WILLIAMETTE DENTAL OF WASHINGTON | 96 | $164K |
| Vision | VISION SOURCE PLAN | 517 | $7K |
| Stop-loss / reinsurancereinsurance | THE UNION LABOR LIFE INSURANCE COMPANY | 1,865 | $968K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,865 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.