| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CAPITAL BENEFIT SERVICES, INC.3 Filed as: CAPITAL BENEFIT SERVICES INC | 15375 SE 30TH PL, #380 BELLEVUE, WA 98007 | REGENCE BLUESHIELD | $6.5M | $1.0M | $7.5M | 5.50% |
| CAPITAL BENEFIT SERVICES, INC.3 Filed as: CAPITAL BENEFIT SERVICES INC | 15375 SE 30TH PL, #380 BELLEVUE, WA 98007 | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON OPTIONS, INC | $1.2M | $0 | $1.2M | 7.30% |
| CAPITAL BENEFIT SERVICES, INC.3 Filed as: CAPITAL BENEFIT SERVICES INC | 15375 SE 30TH PL, #380 BELLEVUE, WA 98007 | DELTA DENTAL OF WASHINGTON | $942K | $0 | $942K | 7.00% |
| CAPITAL BENEFIT SERVICES, INC.3 Filed as: CAPITAL BENEFIT SERVICES INC | 15375 SE 30TH PL #380 BELLEVUE, WA 98007 | ASURIS NORTHWEST HEALTH | $159K | $36K | $196K | 7.58% |
| CAPITAL BENEFIT SERVICES, INC.3 Filed as: CAPITAL BENEFIT SERVICES INC | 15375 SE 30TH PL, #380 BELLEVUE, WA 98007 | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON | $184K | $0 | $184K | 7.38% |
| CAPITAL BENEFIT SERVICES, INC.3 Filed as: CAPITAL BENEFIT SERVICES INC | 15375 SE 30TH PL, #380 BELLEVUE, WA 98007 | LIFEMAP ASSURANCE COMPANY | $170K | $0 | $170K | 18.94% |
| CAPITAL BENEFIT SERVICES, INC.3 Filed as: CAPITAL BENEFIT SERVICES INC | 15375 SE 30TH PL, #380 BELLEVUE, WA 98007 | LIFEMAP ASSURANCE COMPANY | $52K | $0 | $52K | 8.00% |
| CAPITAL BENEFIT SERVICES, INC.3 Filed as: CAPITAL BENEFIT SERVICES INC | 15375 SE 30TH PL, #380 BELLEVUE, WA 98007 | MAGELLAN HEALTHCARE | $15K | $0 | $15K | 12.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| EPK AND ASSOCIATES, INC. EIN 91-1947441 PLAN ADMINISTRATOR | Plan Administrator; Direct payment from the plan Service code 14 | — | $4.0M |
| PERKINS COIE EIN 91-0591206 LAWYER | Legal; Direct payment from the plan Service code 29 | — | $160K |
| KEY TRUST COMPANY EIN 34-0797057 TRUSTEE CUSTODIAN | Direct payment from the plan; Trustee (bank, trust company, or similar financial institution) Service code 21 | — | $50K |
| SWEENEY CONRAD, P.S. EIN 91-1301672 ACCOUNTANT | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $26K |
| FEDERAL INSURANCE COMPANY EIN 13-1963496 INSURER | Direct payment from the plan; Insurance agents and brokers 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 | 23,589 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 310 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 23,899 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(5 contracts, 5 carriers) | REGENCE BLUESHIELD | 30,761 | $158.8M |
| Dental(3 contracts, 3 carriers) | REGENCE BLUESHIELD | 30,761 | $152.8M |
| Vision(3 contracts, 3 carriers) | REGENCE BLUESHIELD | 30,761 | $140.0M |
| Life insurance | LIFEMAP ASSURANCE COMPANY | 0 | $898K |
| Short-term disability | LIFEMAP ASSURANCE COMPANY | 0 | $898K |
| Prescription drug(5 contracts, 5 carriers) | REGENCE BLUESHIELD | 30,761 | $158.8M |
| Other | REGENCE BLUESHIELD | 30,761 | $136.7M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 30,761 | — |
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.