| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| INTERREMEDY INSURANCE SERVICES3 | 315 MONTGOMERY STREET ST 900 SAN FRANCISCO, CA 94104 | COMPANION LIFE OF COLUMBIA, SC | $70K | — | $70K | 7.00% |
| VISION SOURCE PLAN3 | 3333 QUALITY DRIVE RANCHO CORDOVA, CA 95707 | VISION SOURCE PLAN | — | — | $0 | 0.00% |
| PROPEL INSURANCE3 | 601 UNION STREET, SUITE 3400 SEATTLE, WA 98101 | WILLIAMETTE DENTAL OF WASHINGTON | — | $15K | $15K | 11.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| PREMERA EIN 91-0499247 CLAIMS CONSULTANT | Other services; Other fees Service code 49 | PO BOX 327 SEATTLE, WA 98111 | $615K |
| DIANA CLARK EIN 91-6061910 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $125K |
| BRIDGEWAY INC. EIN 22-2224737 IT SUPPORT PROVIDER | Other services; Direct payment from the plan Service code 49 | 270 ROUTE 28 BRIDGEWATER, NJ 08807 | $120K |
| WASHINGTON CAPITAL MANAGEMENT. INC. EIN 91-1042342 INVESTMENT CUSTODIAN | Investment management fees paid directly by plan Service code 51 | 1200 SIXTH AVENUE, SUITE 700 SEATTLE, WA 98101 | $105K |
| PROPEL INSURANCE EIN 91-0436970 | Insurance agents and brokers; Consulting (general); Insurance brokerage commissions and fees Service code 16 | 601 UNION STREET, SUITE 3400 SEATTLE, WA 98101 | $72K |
| MICHAEL HASENAUER EIN 91-6061910 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $70K |
| SHAUN-DEE WILLIAMS EIN 91-6061910 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $67K |
| CINDY MATTINGLY EIN 91-6061910 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $65K |
| SUSAN MCGIVERN EIN 91-6061910 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $65K |
| KEY BANK EIN 91-1382589 CUSTODIAL | Custodial (securities); Direct payment from the plan Service code 19 | PO BOX 7453 CLEVELAND, OH 441944543 | $58K |
| QUADIENT FINANCE USA, INC. EIN 16-1753763 PRINTING SERVICES | Direct payment from the plan; Other services Service code 49 | 478 WHEELERS FARMS RD. MILFORD, CT 06461 | $35K |
| TEAMSTERS LOCAL UNION #313 EIN 91-0436970 LESSOR | Direct payment from the plan; Other services Service code 49 | 220 S. 27TH ST TACOMA, WA 98402 | $30K |
| BARLOW, COUGHRAN, MORALES, & JOSEPH EIN 92-0089852 ATTORNEY | Legal; Direct payment from the plan Service code 29 | 1325 FOURTH AVE, STE 910 SEATTLE, WA 981012573 | $29K |
| MILLER KAPLAN ARASE LLP EIN 95-2036255 ACCOUNTANT | Direct payment from the plan; Other services; Accounting (including auditing) Service code 10 | 600 STEWART STREET, SUITE 618 SEATTLE, WA 98101 | $25K |
| ALTA CPA GROUP LLC. EIN 82-1650312 ACCOUNTANT | Direct payment from the plan; Accounting (including auditing) Service code 10 | 59. FRANKLIN ST. ANNAPOLIS, MD 21401 | $18K |
| PRINT NW EIN 91-1648652 PRINTING SERVICES | Other services; Direct payment from the plan Service code 49 | 9914 32ND AVE. S. LAKEWOOD, WA 98499 | $17K |
| COMCAST EIN 27-0000798 INTERNET SERVICE PROVIDER | Other services; Direct payment from the plan Service code 49 | 1701 JOHN F. KENNEDY BLVD. PHILADELPHIA, PA 19103 | $7K |
| AH! THE ELEMENT OF SURPRISE, LLC. CONSULTANT | Direct payment from the plan; Consulting (general) Service code 16 | P.O. BOX 26692 FEDERAL WAY, WA 98093 | $6K |
| PACIFIC OFFICE AUTOMATION EIN 93-0665413 LESSOR | Other services; Direct payment from the plan Service code 49 | 14747 NW. GREENBRIER PKWY. BEARVERTON, OR 97006 | $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 | 2,036 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 17 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 2,053 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | WILLIAMETTE DENTAL OF WASHINGTON | 260 | $133K |
| Vision | VISION SOURCE PLAN | 1,090 | $154K |
| Stop-loss / reinsurancereinsurance | COMPANION LIFE OF COLUMBIA, SC | 2,055 | $994K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,055 | — |
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.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.