| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CAPITAL BENEFIT SERVICES, INC.3 | 15375 SE 30TH PL SUITE 380 BELLEVUE, WA 98007 | REGENCE BLUESHIELD | $6.7M | $1.2M | $7.9M | 5.70% |
| CAPITAL BENEFIT SERVICES, INC.3 | 15375 SE 30TH PL SUITE 380 BELLEVUE, WA 98007 | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON OPTIONS, INC. | $1.2M | — | $1.2M | 7.11% |
| CAPITAL BENEFIT SERVICES, INC.3 | 15375 SE 30TH PL SUITE 380 BELLEVUE, WA 98007 | DELTA DENTAL OF WASHINGTON | $999K | — | $999K | 7.00% |
| CAPITAL BENEFIT SERVICES, INC.3 | 15375 SE 30TH PL SUITE 380 BELLEVUE, WA 98007 | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON | $228K | — | $228K | 7.23% |
| CAPITAL BENEFIT SERVICES, INC.3 | 15375 SE 30TH PL SUITE 380 BELLEVUE, WA 98007 | ASURIS NORTHWEST HEALTH | $132K | $49K | $181K | 6.66% |
| CAPITAL BENEFIT SERVICES, INC.3 | 15375 SE 30TH PL SUITE 380 BELLEVUE, WA 98007 | LIFEMAP ASSURANCE COMPANY | $111K | — | $111K | 13.18% |
| CAPITAL BENEFIT SERVICES, INC.3 | 15375 SE 30TH PL SUITE 380 BELLEVUE, WA 98007 | LIFEMAP ASSURANCE COMPANY | $58K | — | $58K | 8.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| EPK & ASSOCIATES, INC. EIN 91-1947441 PLAN ADMINISTRATOR | Direct payment from the plan; Plan Administrator Service code 14 | — | $4.0M |
| FIRST CHOICE HEALTH EIN 91-1272766 EMPLOYEE ASSISTANCE | Direct payment from the plan; Other services Service code 49 | — | $132K |
| PERKINS COIE EIN 91-0591206 LAWYER | Legal; Direct payment from the plan Service code 29 | — | $68K |
| SWEENEY CONRAD, P.S. EIN 91-1301672 ACCOUNTANT | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $30K |
| CHARLES SCHWAB & CO., INC. EIN 94-1737782 TRUSTEE/CUSTODIAN | Trustee (bank, trust company, or similar financial institution); Direct payment from the plan Service code 21 | — | $27K |
| KEY TRUST COMPANY EIN 34-0797057 TRUSTEE/CUSTODIAN | Direct payment from the plan; Trustee (bank, trust company, or similar financial institution) Service code 21 | — | $22K |
| CHUBB INSURANCE COMPANY EIN 13-2595722 INSURANCE AGENT | Insurance agents and brokers; Direct payment from the plan Service code 22 | — | $17K |
| CAPITAL BENEFIT SERVICES, INC. HR, COMPLIANCE ASSISTANCE | Other services; Direct payment from the plan Service code 49 | 15375 SE 30TH PL SUITE 380 BELLEVUE, WA 98007 | $7K |
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 | 21,540 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 195 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 21,735 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 4 carriers) | REGENCE BLUESHIELD | 27,743 | $161.9M |
| Dental | DELTA DENTAL OF WASHINGTON | 29,478 | $14.3M |
| Vision(3 contracts, 3 carriers) | REGENCE BLUESHIELD | 27,743 | $142.5M |
| Life insurance | LIFEMAP ASSURANCE COMPANY | 21,407 | $842K |
| Prescription drug(4 contracts, 4 carriers) | REGENCE BLUESHIELD | 27,743 | $161.9M |
| Other(2 contracts, 2 carriers) | REGENCE BLUESHIELD | 27,743 | $139.9M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 29,478 | — |
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.