| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| INTERREMEDY INSURANCE SERVICES3 Filed as: INTERREMEDY INSURANCE SERVICES LLC | 315 MONTGOMERY STREET SUITE 900 SAN FRANCISCO, CA 94104 | HCC LIFE INSURANCE COMPANY | $27K | — | $27K | 5.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| PREMERA BLUE CROSS NONE | Direct payment from the plan; Claims processing Service code 12 | PO BOX 91060 SEATTLE, WA 98111 | $376K |
| A.W. REHN EIN 91-1008626 NONE | Direct payment from the plan; Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 13 | — | $333K |
| UNITED CLAIMS SOLUTIONS NONE | Direct payment from the plan; Consulting (general) Service code 16 | 23048 N 15TH AVE PHOENIX, AZ 85027 | $208K |
| INNOVATIVE CASE MANAGEMENT EIN 91-1087669 NONE | Consulting (general); Direct payment from the plan Service code 16 | — | $72K |
| EXPRESS SCRIPTS NONE | Direct payment from the plan; Claims processing Service code 12 | ONE EXPRESS WAY ST. LOUIS, MO 63121 | $42K |
| PROPEL INSURANCE EIN 91-0830024 NONE | Consulting (general); Direct payment from the plan Service code 16 | — | $39K |
| TURNER, STOEVE, AND GAGLIARDI EIN 91-0774959 NONE | Legal; Direct payment from the plan Service code 29 | — | $27K |
| CLIFTONLARSONALLEN, LLP EIN 41-0746749 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $17K |
| NORTHWEST ADMINSTRATORS, INC. EIN 91-0680697 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $9K |
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 | 1,512 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,515 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | WILLAMETTE DENTAL OF WASHINGTON,INC. | 217 | $83K |
| Stop-loss / reinsurancereinsurance | HCC LIFE INSURANCE COMPANY | 1,409 | $539K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,409 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.