| 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 | $206K | $12K | $219K | 5.39% |
| CAPITAL BENEFIT SERVICES, INC.3 Filed as: CAPITAL BENEFIT SERVICES INC | 15375 SE 30TH PL #380 BELLEVUE, WA 98007 | ASURIS NORTHWEST HEALTH | $34K | $2K | $36K | 5.79% |
| CAPITAL BENEFIT SERVICES, INC.3 Filed as: CAPITAL BENEFIT SERVICES INC | 15375 SE 30TH PL #380 BELLEVUE, WA 98007 | LIFEMAP ASSURANCE COMPANY | $8K | $0 | $8K | 9.83% |
| CAPITAL BENEFIT SERVICES, INC.3 Filed as: CAPITAL BENEFIT SERVICES, INC | 15375 SE 30TH PL #380 BELLEVUE, WA 98007 | LIFEMAP ASSURANCE COMPANY | $5K | $0 | $5K | 12.05% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| EPK AND ASSOCIATES EIN 91-1947441 ADMINISTRATOR | Direct payment from the plan; Plan Administrator Service code 14 | — | $162K |
| SWEENEY CONRAD, P.S. EIN 91-1301672 ACCOUNTANT | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $6K |
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 | 14,084 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 90 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 14,174 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | REGENCE BLUESHIELD | 12,112 | $4.7M |
| Dental(3 contracts, 3 carriers) | REGENCE BLUESHIELD | 12,112 | $4.8M |
| Vision(2 contracts, 2 carriers) | REGENCE BLUESHIELD | 12,112 | $4.7M |
| Life insurance | LIFEMAP ASSURANCE COMPANY | 9,452 | $39K |
| Short-term disability | LIFEMAP ASSURANCE COMPANY | 9,452 | $39K |
| Prescription drug(2 contracts, 2 carriers) | REGENCE BLUESHIELD | 12,112 | $4.7M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 12,112 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.