Form 5500 · Employee benefit plan · SEATTLE, WA
BOARD OF TRUSTEES, THE BLEDSOE HEALTH TRUST
The filing calls this plan THE BLEDSOE HEALTH TRUST.
BOARD OF TRUSTEES, THE BLEDSOE HEALTH TRUST of SEATTLE, WA is a 3,999-participant agriculture employer — a large group whose insured benefits are disclosed on Schedule A of its Form 5500. Coverage is written through REGENCE BLUECROSS BLUESHIELD and 3 other carriers. The plan's most recent policy period ended in December.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 93-0478837 · plan 501 · plan year 2025, filed Mar 16, 2026
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How this plan is funded
Self-funded as reported
The filing reports benefits paid from the plan's own money, and no medical insurance contract on Schedule A.
A stop-loss policy appears on a Form 5500 only when the plan itself is the beneficiary, or the premiums are paid from plan money. Many employers buy stop-loss and never report it here. So a plan with no stop-loss on its filing may still have it.
Benefits declared on this filing
Also declared: other welfare.
Declared benefits are the plan’s own line 8b codes on Form 5500. “Not on Schedule A” means no insured contract for that line appears on this filing. That usually means the benefit is self-funded, or it sits under a different plan number.
Where a line has more than one insured contract, the carrier and the covered figure are the largest contract's by premium. The contracts are not added up: a pharmacy carve-out and the medical carrier beside it cover the same people.
Persons covered is the count the carrier filed for that policy at the end of its policy year, and it can include dependents. Participants is the plan's own count at the start of its plan year. The two count different people, so a covered figure can be larger.
Plan brief
Schedule A lists 5 insured contracts covering health, dental, vision and life; the largest, with REGENCE BLUECROSS BLUESHIELD, covers 1,146 people.
The filing declares health, dental, vision, life and disability. Disability appears with no insured contract on Schedule A. That coverage may be self-funded, or placed with a carrier that is not on this filing.
Reported premium is $3,033,648; the filing discloses no broker commission on these contracts.
The health contract's policy period ended in December, while at least one ancillary line's policy period ended in May. The plan is on a split renewal cycle.
No broker of record is named on the Schedule A. The contracts may be written directly with the carrier, or the broker fields were left blank on the filing.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| REGENCE BLUECROSS BLUESHIELD | Health, Dental, Vision | 1,146 | Jan 1, 2025 | $1,691,516 | $0 |
| WILLAMETTE DENTAL INSURANCE, INC. | Health, Dental | 2,166 | Jun 1, 2025 | $688,414 | $0 |
| LIFEMAP ASSURANCE COMPANY | Life | 2,742 | Jan 1, 2025 | $262,284 | $0 |
| USABLE LIFE | Life | 2,780 | Jun 1, 2025 | $214,064 | $0 |
| WILLAMETTE DENTAL INSURANCE, INC. | Health, Dental | 398 | Jun 1, 2025 | $177,370 | $0 |
Premium and claims on these contracts
WILLAMETTE DENTAL INSURANCE, INC., contract OR148. For the contract year on this filing, the carrier reported $688,414 in premium earned and $514,194 in claims incurred. Dividing one by the other gives 75%.
WILLAMETTE DENTAL INSURANCE, INC., contract OR149. For the contract year on this filing, the carrier reported $177,370 in premium earned and $140,775 in claims incurred. Dividing one by the other gives 79%.
- WILLAMETTE DENTAL INSURANCE, INC., contract OR148 reported $58,515 in retention.
- WILLAMETTE DENTAL INSURANCE, INC., contract OR149 reported $16,850 in retention.
Retention is what the carrier kept of the premium after claims, as reported: administration, commissions and other charges.
Only experience-rated contracts report these figures, so most filings leave them blank.
Covered = persons covered at policy year end, as filed on Schedule A for that policy — often certificates or one class, not the whole plan. Premium = the filing’s own premium/charges figure; “—” means not credibly reported.
Administrator and service providers
The plan administrator is from line 3a of the main form. The service providers are named on Schedule C of this filing. We publish company names only.
Money the plan held and paid out
Sourced from U.S. DOL EFAST2 Form 5500 · Schedule H
These are the plan's own figures from Schedule H, the financial statement it files. They are not the premium on Schedule A.
How this plan compares
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