| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DIMARTINO ASSOCIATES4 | 1501 4TH AVE. 2400 SEATTLE, WA 98101 | KAISER FOUNDATION HEALTH PLAN | — | $4K | $4K | 0.10% |
| THE MILLIMAN AGENCY INC Filed as: MILLIMAN INC. | — | WILLAMETTE DENTAL GROUP | — | — | $0 | 0.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| WELFARE & PENSION ADMIN SERVICES EIN 91-1363171 THIRD PARTY ADMINISTRATOR | Plan Administrator Service code 14 | 2815 2ND AVENUE SUITE 300 SEATTLE, WA 98121 | $628K |
| PREMERA EIN 91-0499247 CLAIMS PROCESSING | Claims processing Service code 12 | PO BOX 91080 SEATTLE, WA 98111 | $376K |
| INNOVATIVE CARE MANAGEMENT EIN 93-1087669 MEDICAL MANAGEMENT | Direct payment from the plan; Other services; Insurance services Service code 23 | 15 82ND DRIVE, SUITE 180 GLADSTONE, OR 97027 | $124K |
| MILLER NASH LLP EIN 93-0410518 LEGAL COUNSEL | Legal Service code 29 | 111 SW 5TH AVE, 3400 PORTLAND, OR 972043699 | $89K |
| BRWN& BRWN OF WA DBA DIMARTINO ASSC EIN 91-0378940 PLAN CONSULTANTS | Consulting (general) Service code 16 | 1501 4TH AVENUE, STE 2400 SEATTLE, WA 98101 | $84K |
| AGC-IUOE LOCAL 701 TRAINING TRUST EIN 93-0634959 PAYROLL AUDIT/DELINQUEY | Other fees Service code 99 | P.O. BOX 34203 SEATTLE, WA 98124 | $71K |
| PENN CAPITAL MANAGEMENT EIN 22-2796848 INVESTMENT MANAGER | Investment management; Investment management fees paid directly by plan Service code 28 | 3 CRESCENT DRIVE SUITE 40 PHILADELPHIA, PA 19112 | $49K |
| BENNETT, HARTMAN, MORRIS & KAPLAN EIN 93-0633539 COLLECTION ATTORNEY | Legal; Direct payment from the plan Service code 29 | 210 SW MORISON ST,STE 500 PORTLAND, OR 97204 | $41K |
| VISION SERVICE PLAN CLAIMS ADMINISTRATION | Contract Administrator; Direct payment from the plan Service code 13 | — | $32K |
| QUEST INVESTMENTS MGMT INC EIN 93-0880854 INVESTMENT MANAGER | Investment management fees paid directly by plan; Investment management Service code 28 | ONE SW COLUMBIA ST 1100 PORTLAND, OR 97258 | $28K |
| BJORKLUND & MONTPLAISIR EIN 93-1015766 AUDITING | Accounting (including auditing) Service code 10 | 9020 SW WASHINGTON SQ 46 PORTLAND, OR 972234433 | $17K |
| BANK OF AMERICA EIN 94-1687665 BANKING SERVICES | Trustee (bank, trust company, or similar financial institution) Service code 21 | PO BOX 15284 WILMINGTON, DE 19850 | $12K |
| AMALGAMATED BANK EIN 13-4920330 INVESTMENT CUSTODIAN | Custodial (other than securities) Service code 18 | 472 EAST COLORAFO BOULEVA PASADENA, CA 91101 | $8K |
| NEW ENGLAND PENSION CONSULTANTS EIN 04-2927339 INVESTMENT MONITOR | Direct payment from the plan; Investment advisory (plan) Service code 27 | 6332 SOUTH RAINBOW BLVD LAS VEGAS, NV 89118 | $8K |
| CHANGE HEALTHCARE EIN 20-5591816 CLAIMS SERVICES | Other insurance fees and expenses Service code 73 | 3055 LEBANON PIKE NASHVILLE, TN 37214 | $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 | 1,968 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,968 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN | 795 | $4.2M |
| Dental | WILLAMETTE DENTAL GROUP | 647 | $210K |
| Vision | VISION SERVICE PLAN | 1,684 | $92K |
| Life insurance | LIFEMAP ASSURANCE COMPANY | 1,989 | $107K |
| Short-term disability | LIFEMAP ASSURANCE COMPANY | 1,989 | $107K |
| Stop-loss / reinsurancereinsurance | THE UNION LABOR LIFE INSURANCE COMPANY | 1,711 | $1.1M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,989 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.