| 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 | $6.6M | $1.2M | $7.7M | 5.59% |
| 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. | $993K | $0 | $993K | 7.46% |
| CAPITAL BENEFIT SERVICES, INC.3 Filed as: CAPITAL BENEFIT SERVICES INC | 15375 SE 30TH PL, #380 BELLEVUE, WA 98007 | DELTA DENTAL OF WASHINGTON | $936K | $0 | $936K | 7.36% |
| 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 | $224K | $0 | $224K | 7.49% |
| CAPITAL BENEFIT SERVICES, INC.3 Filed as: CAPITAL BENEFIT SERVICES INC | 15375 SE 30TH PL, #380 BELLEVUE, WA 98007 | ASURIS NORTHWEST HEALTH | $142K | $48K | $190K | 6.35% |
| CAPITAL BENEFIT SERVICES, INC.3 Filed as: CAPITAL BENEFIT SERVICES INC | 15375 SE 30TH PL, #380 BELLEVUE, WA 98007 | LIFEMAP ASSURANCE COMPANY | $169K | $0 | $169K | 19.61% |
| CAPITAL BENEFIT SERVICES, INC.3 Filed as: CAPITAL BENEFIT SERVICES INC | 15375 SE 30TH PL, #380 BELLEVUE, WA 98007 | LIFEMAP ASSURANCE COMPANY | $56K | — | $56K | 8.00% |
| 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 | — | $118K |
| KEY TRUST COMPANY EIN 34-0797057 TRUSTEE CUSTODIAN | Direct payment from the plan; Trustee (bank, trust company, or similar financial institution) Service code 21 | — | $61K |
| SWEENEY CONRAD, P.S. EIN 91-1301672 ACCOUNTANT | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $27K |
| FEDERAL INSURANCE COMPANY EIN 13-1963496 INSURER | Insurance agents and brokers; Direct payment from the plan Service code 22 | — | $17K |
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 | 22,408 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 279 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 22,687 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 4 carriers) | REGENCE BLUESHIELD | 30,510 | $157.6M |
| Dental(2 contracts, 2 carriers) | REGENCE BLUESHIELD | 30,510 | $151.0M |
| Vision(3 contracts, 3 carriers) | REGENCE BLUESHIELD | 30,510 | $142.0M |
| Life insurance | LIFEMAP ASSURANCE COMPANY | 22,668 | $860K |
| Short-term disability | LIFEMAP ASSURANCE COMPANY | 22,668 | $860K |
| Prescription drug(4 contracts, 4 carriers) | REGENCE BLUESHIELD | 30,510 | $157.6M |
| Other | REGENCE BLUESHIELD | 30,510 | $138.3M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 30,510 | — |
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.