| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CAPITAL BENEFIT SERVICES, INC.3 Filed as: CAPITAL BENEFITS SERVICES INC | 15375 SE 30TH PL #380 BELLEVUE, WA 98007 | REGENCE BLUESHIELD | $6.2M | $947K | $7.2M | 5.45% |
| CAPITAL BENEFIT SERVICES, INC.3 Filed as: CAPITAL BENEFITS SERVICES INC | 15375 SE 30TH PL #380 BELLEVUE, WA 98007 | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON OPTIONS, INC. | $1.5M | $0 | $1.5M | 7.39% |
| CAPITAL BENEFIT SERVICES, INC.3 Filed as: CAPITAL BENEFITS SERVICES INC | 15375 SE 30TH PL #380 BELLEVUE, WA 98007 | DELTA DENTAL OF WASHINGTON | $847K | $0 | $847K | 6.41% |
| CAPITAL BENEFIT SERVICES, INC.3 Filed as: CAPITAL BENEFIT SERVICES INC | 15375 SE 30TH PL #380 BELLEVUE, WA 98007 | ASURIS NORTHWEST HEALTH | $146K | $27K | $173K | 6.93% |
| CAPITAL BENEFIT SERVICES, INC.3 Filed as: CAPITAL BENEFITS SERVICES INC | 15375 SE 30TH PL #380 BELLEVUE, WA 98007 | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON | $140K | $0 | $140K | 7.03% |
| CAPITAL BENEFIT SERVICES, INC.3 Filed as: CAPITAL BENEFITS SERVICES INC | 15375 SE 30TH PL #380 BELLEVUE, WA 98007 | LIFEMAP ASSURANCE COMPANY | $119K | $0 | $119K | 13.06% |
| CAPITAL BENEFIT SERVICES, INC.3 Filed as: CAPITAL BENEFITS SERVICES INC | 15375 SE 30TH PL #380 BELLEVUE, WA 98007 | LIFEMAP ASSURANCE COMPANY | $46K | $0 | $46K | 8.00% |
| CAPITAL BENEFIT SERVICES, INC.3 Filed as: CAPITAL BENEFITS SERVICES INC | 15375 SE 30TH PL #380 BELLEVUE, WA 98007 | MAGELLAN HEALTHCARE | $12K | $0 | $12K | 9.92% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| EPK AND ASSOCIATES, INC. EIN 91-1947441 PLAN ADMINISTRATOR | Direct payment from the plan; Plan Administrator Service code 14 | — | $3.8M |
| PERKINS COIE EIN 91-0591206 LAWYER | Legal; Direct payment from the plan Service code 29 | — | $320K |
| MERCER HEALTH & BENEFITS LLC CONSULTING | Consulting (general) Service code 16 | 1301 5TH AVE #1900 SEATTLE, WA 98101 | $65K |
| KEY TRUST COMPANY EIN 34-0797057 TRUSTEE CUSTODIAN | Trustee (bank, trust company, or similar financial institution); Direct payment from the plan Service code 21 | — | $49K |
| PRINTWEST PRINTING SERVICES | Copying and duplicating; Direct payment from the plan Service code 36 | 6101 238TH STREET SE WOODINVILLE, WA 98072 | $34K |
| SWEENEY CONRAD, P.S. EIN 91-1301672 ACCOUNTANT | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $25K |
| SHORETT COMMUNICATIONS, LLC EIN 91-2196270 MARKETER | Direct payment from the plan; Other services Service code 49 | — | $17K |
| FEDERAL INSURANCE COMPANY EIN 13-1963496 INSURER | Insurance agents and brokers; Direct payment from the plan Service code 22 | — | $16K |
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 | 33,862 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 370 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 34,232 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(5 contracts, 5 carriers) | REGENCE BLUESHIELD | 31,034 | $156.3M |
| Dental(3 contracts, 3 carriers) | REGENCE BLUESHIELD | 31,034 | $147.0M |
| Vision(3 contracts, 3 carriers) | REGENCE BLUESHIELD | 31,034 | $134.3M |
| Life insurance | LIFEMAP ASSURANCE COMPANY | 24,539 | $912K |
| Short-term disability | LIFEMAP ASSURANCE COMPANY | 24,539 | $912K |
| Prescription drug(5 contracts, 5 carriers) | REGENCE BLUESHIELD | 31,034 | $156.3M |
| Other | REGENCE BLUESHIELD | 31,034 | $131.3M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 31,034 | — |
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.
Multiple-employer welfare arrangement. Specific regulatory and compliance context; specific consultant niche.