| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| INTERREMEDY INSURANCE SERVICES3 | 315 MONTGOMERY STREET,SUITE 900 SAN FRANCISCO, CA 94104 | SYMETRA LIFE INSURANCE COMPANY | $13K | — | $13K | 5.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ASSOCIATED THIRD PARTY ADMINISTRATO EIN 94-3187938 NONE | Contract Administrator; Claims processing; Copying and duplicating; Participant communication; Recordkeeping and information management (computing, tabulating, data processing, etc.); Direct payment from the plan Service code 12 | — | $868K |
| MULTIPLAN SERVICES CORP EIN 06-1533300 NONE | Other services; Claims processing; Direct payment from the plan Service code 12 | — | $344K |
| ZENITH AMERICAN SOLUTIONS EIN 52-1590516 NONE | Direct payment from the plan; Contract Administrator; Claims processing; Copying and duplicating; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | — | $223K |
| INNOVATIVE CARE MANAGEMENT, INC. EIN 93-1087669 NONE | Other services; Insurance services; Direct payment from the plan Service code 23 | — | $168K |
| PROVIDENCE PLAN PARTNERS EIN 91-1861964 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $64K |
| US BANK, N.A. EIN 31-0841368 NONE | Custodial (securities); Direct payment from the plan; Other services; Float revenue; Soft dollars commissions Service code 19 | — | $64K |
| LINDQUIST LLP EIN 52-2385296 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $52K |
| PROPEL INSURANCE EIN 91-0830024 NONE | Direct payment from the plan; Consulting (general); Insurance agents and brokers Service code 16 | — | $48K |
| MCKENZIE ROTHWELL BARLOW & COUGHRAN EIN 91-0889948 NONE | Legal; Direct payment from the plan Service code 29 | — | $29K |
| MILLIMAN, INC. EIN 91-0675641 NONE | Actuarial; Direct payment from the plan Service code 11 | — | $29K |
| TORI GETER NONE | Consulting (general); Direct payment from the plan Service code 16 | 1425 NW GARFIELD AVENUE CORVALLIS, OR 97330 | $27K |
| VERUS ADVISORY, INC. EIN 91-1320111 NONE | Investment advisory (plan); Direct payment from the plan; Consulting (pension) Service code 17 | — | $20K |
| BROWNSTEIN RASK, LLP EIN 93-0589000 NONE | Legal; Direct payment from the plan Service code 29 | — | $18K |
| EXPRESS SCRIPTS EIN 43-1420563 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $9K |
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 | 2,363 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 912 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 3,275 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | 4,214 | $18.2M |
| Dental(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | 4,214 | $18.4M |
| Vision | VISION SERVICE PLAN | 3,458 | $318K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 8,147 | $703K |
| Stop-loss / reinsurancereinsurance | SYMETRA LIFE INSURANCE COMPANY | 1,403 | $261K |
| Other | METROPOLITAN LIFE INSURANCE COMPANY | 8,147 | $703K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 8,147 | — |
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 comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.