Form 5500 · Employee benefit plan · AIRWAY HEIGHTS, WA
KALISPEL TRIBAL ECONOMIC AUTHORITY
The filing calls this plan KALISPEL TRIBAL ECONOMIC AUTHORITY MEDICAL PLAN.
KALISPEL TRIBAL ECONOMIC AUTHORITY of AIRWAY HEIGHTS, WA is a 1,463-participant arts, entertainment and recreation employer whose group benefits are disclosed in its annual Form 5500 filing. Coverage is written through KAISER FOUNDATION HEALTH PLAN OF WASHINGTON OPTIONS, INC. and 1 other carrier. The plan's most recent policy period ended in December.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 91-2054433 · plan 501 · plan year 2024, filed Dec 5, 2025
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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
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
All 2 insured contracts are health coverage, split across KAISER FOUNDATION HEALTH PLAN OF WASHINGTON OPTIONS, INC. and KAISER FOUNDATION HEALTH PLAN OF WASHINGTON.
Reported premium is $15,108,687; the filing discloses no broker commission on these contracts.
The most recent policy period ended in December, and the plan year ends December 31. Group contracts typically renew on that annual 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.
Two carriers split the book: KAISER FOUNDATION HEALTH PLAN OF WASHINGTON OPTIONS, INC. and KAISER FOUNDATION HEALTH PLAN OF WASHINGTON.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| KAISER FOUNDATION HEALTH PLAN OF WASHINGTON OPTIONS, INC. | Health | 1,486 | Jan 1, 2025 | $12,625,030 | $0 |
| KAISER FOUNDATION HEALTH PLAN OF WASHINGTON | Health | 355 | Jan 1, 2025 | $2,483,657 | $0 |
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.
Other plans filed by this employer
How this plan compares
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