| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PROPEL INSURANCE3 | 1201 PACIFIC AVE. 1000 TACOMA, WA 98402 | RELIASTAR LIFE INSURANCE COMPANY | $71K | — | $71K | 8.00% |
| INTERREMEDY INSURANCE SERVICES3 Filed as: INTERREMEDY INSURANCE SERVICES, LLC | 2268 WESTBOROUGH BLVD. STE. 302-328 SOUTH SAN FRANCISCO, CA 94080 | RELIASTAR LIFE INSURANCE COMPANY | $62K | — | $62K | 7.00% |
| PROPEL INSURANCE AGENCY LLC3 | P.O. BOX 2940 TACOMA, WA 98401 | SYMETRA LIFE INSURANCE COMPANY | $6K | — | $6K | 9.90% |
| CENTERSTONE INSURANCE AND FINANCIAL3 Filed as: CENTERSTONE INSURANCE & FINANC | 4851 LBJ FRWY STE 100 DALLAS, TX 75244 | SYMETRA LIFE INSURANCE COMPANY | — | $2K | $2K | 3.54% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| NORTHWEST ADMINISTRATORS, INC EIN 91-0680697 THIRD PARTY ADMINISTRATOR | Contract Administrator; Direct payment from the plan Service code 13 | — | $815K |
| PREMERA BLUE CROSS EIN 91-0499247 CLAIMS ADMIN/PPO ACCESS | Claims processing; Insurance agents and brokers; Direct payment from the plan Service code 12 | — | $554K |
| INNOVATIVE CARE MANAGEMENT EIN 93-1087669 CLAIMS AUDITING | Insurance services; Other services; Direct payment from the plan Service code 23 | — | $151K |
| DELTA DENTAL EIN 94-1461312 DELTA ADMIN FEE | Claims processing; Direct payment from the plan Service code 12 | — | $94K |
| WASHINGTON CAPITAL MANAGEMENT EIN 91-1042342 INVESTMENT ADVISOR/MGR | Investment management; Investment advisory (plan); Direct payment from the plan Service code 27 | — | $82K |
| WITHUM SMITH & BROWN, PC EIN 52-2385296 PAYROLL AUDITOR | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $71K |
| PROPEL INSURANCE EIN 91-0830024 CONSULTANT | Consulting (general); Direct payment from the plan; Insurance agents and brokers Service code 16 | — | $52K |
| CVS/CAREMARK EIN 05-0304626 RX CLAIMS PROCESSING | Direct payment from the plan; Claims processing Service code 12 | — | $46K |
| LOCKTON COMPANIES LLC EIN 20-3354970 CONSULTANT/RX BENEFIR MGT | Consulting (general); Direct payment from the plan Service code 16 | — | $42K |
| US BANK N.A. EIN 93-0571729 CUSTODIAN/INV. MANAGER | Direct payment from the plan; Custodial (securities); Investment management Service code 19 | — | $37K |
| BARLOW & COUGHRAN, P.S. EIN 91-1008931 LEGAL COUNCEL | Legal; Direct payment from the plan Service code 29 | — | $29K |
| WELLS FARGO EIN 94-1347393 BANKING | Other services; Direct payment from the plan Service code 49 | — | $27K |
| VISION SERVICES PLAN EIN 06-1227840 VISION SERVICE PLAN | Direct payment from the plan; Claims processing Service code 12 | — | $21K |
| PLATFORM CPAS, LLP EIN 88-4342576 AUDITOR | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $17K |
| ABRACADABRA PRINTING EIN 86-3913400 SERVICE PROVIDER | Copying and duplicating; Direct payment from the plan Service code 36 | — | $13K |
| AUDIT SERIVCES, INC EIN 81-0350794 PAYROLL AUDITOR | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $7K |
| MILLIMAN EIN 91-0675641 ACTUARY | Actuarial; Direct payment from the plan Service code 11 | — | $7K |
| CAPITOL CITY PRESS EIN 91-1068832 SERIVCE PROVIDER | Direct payment from the plan; Copying and duplicating Service code 36 | — | $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 | 1,602 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 110 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 1,712 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD | 121 | $602K |
| Vision | VISION SERVICE PLAN | 1,580 | $211K |
| Life insurance | SYMETRA LIFE INSURANCE COMPANY | 1,405 | $63K |
| Stop-loss / reinsurancereinsurance | RELIASTAR LIFE INSURANCE COMPANY | 1,530 | $884K |
| Other | SYMETRA LIFE INSURANCE COMPANY | 1,405 | $63K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,580 | — |
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.