| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BENEFITMALL | 2111 E HIGHLAND AVE PHOENIX, AZ 85016 | THE UNION LIFE INSURANCE COMPANY | $20K | — | $20K | 4.24% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| WELFARE & PENSION ADMIN SERVICE INC EIN 91-1363171 NONE | Accounting (including auditing); Direct payment from the plan; Plan Administrator; Claims processing; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 10 | — | $1.5M |
| PREMERA BLUE CROSS EIN 91-0499247 NONE | Direct payment from the plan; Claims processing; Contract Administrator Service code 12 | — | $1.0M |
| INNOVATIVE CARE MANAGEMENT, INC EIN 93-1087669 NONE | Insurance services; Other services; Direct payment from the plan Service code 23 | — | $289K |
| RAEL & LETSON EIN 94-1701048 NONE | Direct payment from the plan; Insurance agents and brokers; Consulting (general); Actuarial Service code 11 | — | $172K |
| LEGACY LABORATORY SERVICES NONE | Direct payment from the plan; Other services Service code 49 | 1225 NE 2ND AVE PORTLAND, OR 97232 | $96K |
| CHANGE HEALTHCARE EIN 20-5591816 NONE | Other services; Direct payment from the plan Service code 49 | — | $69K |
| FULLY EFFECTIVE EMPLOYEES, INC. EIN 91-1742034 NONE | Direct payment from the plan; Other services Service code 49 | — | $46K |
| SUN LIFE CAPITAL MANAGEMENT LLC EIN 68-0635051 NONE | Investment management; Investment management fees paid directly by plan Service code 28 | — | $45K |
| VISION SERVICE PLAN EIN 23-7089668 NONE | Direct payment from the plan; Insurance services; Claims processing Service code 12 | — | $44K |
| BARLOW COUGHRAN MORALES & JOSEPHSON EIN 91-0889948 NONE | Legal; Direct payment from the plan Service code 29 | — | $37K |
| ELIXER RX SOLUTIONS EIN 90-1011712 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $26K |
| BANK OF AMERICA EIN 94-1687665 | Direct payment from the plan; Trustee (bank, trust company, or similar financial institution); Custodial (other than securities) Service code 18 | — | $25K |
| ANASTASI, MOORE & MARTIN, PLLC EIN 20-8149084 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $25K |
| MARSH & MCLENNAN AGENCY NONE | Insurance agents and brokers; Insurance services; Direct payment from the plan Service code 22 | 501 N RIVERPOINT BLVD SPOKANE, WA 992021659 | $18K |
| AMERICAN INSTITUTE FOR PREV MED NONE | Direct payment from the plan; Other services Service code 49 | 30445 NORTHWESTERN HWY., STE. 350 FARMINGTON HILLS, MI 48334 | $16K |
| VERUS ADVISORY, INC EIN 91-1320111 NONE | Direct payment from the plan; Consulting (pension); Investment advisory (plan) Service code 17 | — | $13K |
| ALASKA VACCINE ASSESSMENT PROGRAM NONE | Direct payment from the plan; Other services Service code 49 | P.O. BOX 1885 CONCORD, NH 03302 | $11K |
| U.S. BANK EIN 31-0841368 NONE | Custodial (securities); Direct payment from the plan Service code 19 | — | $10K |
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 | 3,260 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 687 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 3,947 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | 630 | $3.4M |
| Vision | VISION SERVICE PLAN | 3,728 | $337K |
| Life insurance | THE UNION LABOR LIFE INSURANCE COMPANY | 3,337 | $112K |
| Stop-loss / reinsurancereinsurance | THE UNION LIFE INSURANCE COMPANY | 3,256 | $483K |
| Other | THE UNION LABOR LIFE INSURANCE COMPANY | 3,337 | $112K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 3,728 | — |
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 comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.