Form 5500 · Employee benefit plan · MERCER ISLAND, WA
FRENCH AMERICAN SCHOOL OF PUGET SOUND
The filing calls this plan FRENCH AMERICAN SCHOOL OF PUGET SOUND EMPLOYEE.
FRENCH AMERICAN SCHOOL OF PUGET SOUND of MERCER ISLAND, WA files a Form 5500 with the U.S. Department of Labor disclosing its employee benefit plan. Its broker of record is ACRISURE NORTHWEST PARTNERS. Coverage is written through REGENCE BLUESHIELD and 3 other carriers. The plan's most recent policy period ended in August.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 91-1682584 · plan 501 · plan year 2025, filed Aug 7, 2026
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How this plan is funded
Fully insured as reported
The filing reports medical coverage through an insurance contract on Schedule A, and no money paid for benefits by the plan itself.
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 4 insured contracts covering health, dental, vision and life; the largest, with REGENCE BLUESHIELD, covers 76 people.
Reported premium across the insured contracts is $921,323, with $47,686 in disclosed broker commissions — about 5.2% of premium.
The health contract's policy period ended in August, while at least one ancillary line's policy period ended in December. The plan is on a split renewal cycle.
ACRISURE NORTHWEST PARTNERS is the broker of record on 2 of the 4 contracts; the rest name a different broker or none.
4 carriers appear on the filing, including REGENCE BLUESHIELD, DELTA DENTAL OF WASHINGTON, PRINCIPAL LIFE INSURANCE COMPANY and WILLAMETTE DENTAL OF WASHINGTON, INC.. REGENCE BLUESHIELD writes the largest contract by premium.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| REGENCE BLUESHIELD | Health, Vision | 76 | Sep 1, 2025 | $823,672 | $41,077 |
| PRINCIPAL LIFE INSURANCE COMPANY | Life | 140 | Sep 1, 2025 | $28,686 | $3,404 |
| DELTA DENTAL OF WASHINGTON | Dental | 97 | Jan 1, 2025 | $50,750 | $2,294 |
| WILLAMETTE DENTAL OF WASHINGTON, INC. | Dental | 34 | Sep 1, 2025 | $18,215 | $911 |
Premium and claims on this contract
WILLAMETTE DENTAL OF WASHINGTON, INC., contract FASPS. For the contract year on this filing, the carrier reported $18,215 in premium earned and $15,388 in claims incurred. Dividing one by the other gives 84%.
- WILLAMETTE DENTAL OF WASHINGTON, INC., contract FASPS reported $6,102 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. We publish company names only.
Other plans filed by this employer
How this plan compares
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