| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| INTERREMEDY INSURANCE SERVICES3 | 315 MONTGOMERY STREET ST 900 SAN FRANCISCO, CA 94104 | COMPANION LIFE INSURANCE COMPANY | $75K | — | $75K | 7.00% |
| VISION SOURCE PLAN3 | 3333 QUALITY DRIVE RANCHO CORDOVA, CA 95707 | VISION SOURCE PLAN | — | $11K | $11K | 7.83% |
| PROPEL INSURANCE3 | 601 UNION STREET, SUITE 3400 SEATTLE, WA 98101 | WILLIAMETTE DENTAL OF WASHINGTON | — | $10K | $10K | 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 | $692K |
| INNOVATIVE CARE MANAGEMENT, INC. EIN 93-1087669 CLAIMS CONSULTANT | Other fees; Other services Service code 49 | P.O. BOX 22386 PORTLAND, OR 97269 | $196K |
| BRIDGEWAY BENEFIT TECHNOLOGIES EIN 22-2224737 IT SUPPORT PROVIDER | Other services; Direct payment from the plan Service code 49 | 3700 KOPPERS STREET SUITE 400 BALTIMORE, MD 21227 | $138K |
| DIANA CLARK EIN 91-6061910 EMPLOYEE | Employee (plan) Service code 30 | — | $131K |
| WASHINGTON CAPITAL MANAGEMENT. INC. EIN 91-1042342 INVESTMENT CUSTODIAN | Investment management fees paid directly by plan; Insurance agents and brokers; Consulting (general) Service code 16 | 1200 SIXTH AVENUE, SUITE 700 SEATTLE, WA 98101 | $104K |
| UNITED EMPLOYEE BENEFIT TRUST EIN 91-6061910 EMPLOYEE BENEFITS | Employee (plan sponsor); Direct payment from the plan Service code 35 | 220 S. 27TH ST SUITE B TACOMA, WA 98402 | $81K |
| MICHELE HASENAUER EIN 91-6061910 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $70K |
| SUSAN MCGIVERN EIN 91-6061910 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $69K |
| SHAUN-DEE WILLIAMS EIN 91-6061910 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $68K |
| CINDY MATTINGLY EIN 91-6061910 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $66K |
| PROPEL INSURANCE EIN 91-0830024 CONSULTANT | Insurance agents and brokers; Insurance brokerage commissions and fees; Consulting (general) Service code 16 | 601 UNION STREET, SUITE 3400 SEATTLE, WA 98101 | $65K |
| KEY BANK EIN 91-1382589 CUSTODIAL | Direct payment from the plan; Custodial (securities) Service code 19 | PO BOX 7453 CLEVELAND, OH 441944543 | $49K |
| WESTERN CONFERENCE TEAMSTERS EIN 91-6145047 EMPLOYEE BENEFITS | Direct payment from the plan; Employee (plan sponsor) Service code 35 | 2323 EASTLAKE AVENUE EAST SEATTLE, WA 98102 | $47K |
| NETWORK SECURE SOLUTIONS, LLC IT CONSULTANT | Consulting (general); Direct payment from the plan Service code 16 | — | $46K |
| DELTA DENTAL OF WASHINGTON EIN 91-0621480 CLAIMS CONSULTANT | Direct payment from the plan; Claims processing; Insurance services Service code 12 | 400 FAIRVIEW AVE N 800 SEATTLE, WA 98109 | $40K |
| 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 | $39K |
| PRINT NW EIN 91-1648652 PRINTING SERVICES | Other services; Direct payment from the plan Service code 49 | 9914 32ND AVE. S. LAKEWOOD, WA 98499 | $34K |
| TEAMSTERS LOCAL UNION #313 EIN 91-0436970 LESSOR | Other services; Direct payment from the plan Service code 49 | 220 S. 27TH ST TACOMA, WA 98402 | $32K |
| WAPAL FUND BEHAVIORAL CONSULTANT | Claims processing; Direct payment from the plan Service code 12 | 125 NORTH STATE STREET CONCORD, NH 03301 | $32K |
| BMI AUDIT SERVICES HEALTH CLAIMS AUDITOR | Accounting (including auditing); Direct payment from the plan Service code 10 | 100 E WAYNE ST SUITE 500 SOUTH BEND, IN 46601 | $31K |
| BARLOW, COUGHRAN, MORALES, & JOSEPH EIN 91-0889948 ATTORNEY | Legal; Direct payment from the plan Service code 29 | 1325 FOURTH AVE, STE 910 SEATTLE, WA 981012573 | $29K |
| AH! THE ELEMENT OF SURPRISE, LLC. HR CONSULTANT | Consulting (general) Service code 16 | P.O. BOX 26692 FEDERAL WAY, WA 98093 | $29K |
| PHARMACEUTICAL STRATEGIES GROUP LLC EIN 14-2001350 CLAIMS CONSULTANT | Consulting (general); Direct payment from the plan Service code 16 | 9220 SW BARBOUR BLVD SUITE 119 PORTLAND, OR 97219 | $28K |
| ANASTASI, MOORE & MARTIN, PLLC EIN 20-8149084 ACCOUNTANT | Accounting (including auditing); Direct payment from the plan Service code 10 | 9 S WASHINGTON ST STE 600 SPOKANE, WA 99201 | $22K |
| RENALOGIC, INC. EIN 87-2102410 MANAGED CARE | Claims processing; Direct payment from the plan Service code 12 | 223 W JACKSON BLVD SUITE 604 CHICAGO, IL 60606 | $20K |
| VSP VISION CARE EIN 61-1227840 VISION CONSULTANT | Direct payment from the plan; Claims processing Service code 12 | 3333 QUALITY DRIVE RANCHO CORDOVA, CA 95670 | $17K |
| MAXORPLUS, LTD EIN 75-2676894 CLAIMS PROCESSOR | Claims processing; Direct payment from the plan Service code 12 | 320 S POLK SUITE 200 AMARILLO, TX 79101 | $15K |
| 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 | $14K |
| INTERREMEDY INSURANCE SERVICES LLC EIN 46-3517722 INSURANCE CONSULTANT | Other services; Insurance services; Direct payment from the plan Service code 23 | 315 MONTGOMERY ST SUITE 900 SAN FRANCISCO, CA 94104 | $12K |
| THE TRAVELERS COMPANIES, INC. EIN 41-0518860 INSURANCE PROVIDER | Insurance services; Direct payment from the plan Service code 23 | 485 LEXINGTON AVE. NEW YORK, NY 10017 | $8K |
| GREEN LIGHT COST MANAGEMENT HEALTH CLAIMS REVIEW | Consulting (general); Direct payment from the plan Service code 16 | 17015 NORTH SCOTTSDALE RD SUITE 350 SCOTTSDALE, AZ 85255 | $7K |
| PACIFIC OFFICE AUTOMATION EIN 93-0665413 LESSOR | Other services; Direct payment from the plan Service code 49 | 14747 NW. GREENBRIER PKWY. BEARVERTON, OR 97006 | $7K |
| THE CHUBB CORPORATION EIN 13-2595722 INSURANCE PROVIDER | Insurance services; Direct payment from the plan Service code 23 | 15 MOUNTAIN VIEW RD. PO BOX 1615 WARREN, NJ 07061 | $6K |
| IRON MOUNTAIN EIN 23-2588479 RENTER | Other services; Direct payment from the plan Service code 49 | — | $6K |
| WASHINGTON TEAMSTERS WELFARE TRUST EIN 91-6034673 EMPLOYEE BENEFITS | Direct payment from the plan; Employee (plan sponsor) Service code 35 | 2345 EASTLAKE AVE E SEATTLE, WA 98102 | $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 | 2,306 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 10 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 2,316 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | WILLIAMETTE DENTAL OF WASHINGTON | 214 | $89K |
| Vision | VISION SOURCE PLAN | 543 | $138K |
| Stop-loss / reinsurancereinsurance | COMPANION LIFE INSURANCE COMPANY | 2,301 | $1.1M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,301 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.