Form 5500 · Employee benefit plan · PUYALLUP, WA
KORUM AUTOMOTIVE GROUP, INC.
The filing calls this plan KORUM AUTOMOTIVE GROUP'S HEALTH & WELFARE PLAN.
Public Form 5500 records show how KORUM AUTOMOTIVE GROUP, INC. of PUYALLUP, WA, a retail employer, structures its employee benefits. Its broker of record is PARKER SMITH & FEEK INSURANCE, LLC. Coverage is written through PREMERA BLUE CROSS HMO and 5 other carriers. The plan's most recent policy period ended in December.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 91-2010963 · plan 502 · plan year 2025, filed Jul 13, 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: death benefits, 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 6 insured contracts covering health, dental, vision, life and disability; the largest, with PREMERA BLUE CROSS HMO, covers 81 people.
Reported premium across the insured contracts is $1,258,765, with $55,322 in disclosed broker commissions — about 4.4% of premium.
The most recent policy period ended in December, and the plan year ends December 31. Group contracts typically renew on that annual cycle.
PARKER SMITH & FEEK INSURANCE, LLC is the broker of record on 5 of the 6 contracts; the rest name a different broker or none.
6 carriers appear on the filing, including PREMERA BLUE CROSS HMO, PREMERA BLUE CROSS, DELTA DENTAL OF WASHINGTON and THE LINCOLN NATIONAL LIFE INSURANCE COMPANY. PREMERA BLUE CROSS HMO writes the largest contract by premium.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| PREMERA BLUE CROSS HMO | Health, Vision | 81 | Jan 1, 2026 | $659,993 | $26,400 |
| PREMERA BLUE CROSS | Health, Vision | 81 | Jan 1, 2026 | $484,467 | $19,379 |
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | Life, Disability | 142 | Jan 1, 2026 | $41,456 | $5,826 |
| DELTA DENTAL OF WASHINGTON | Dental | 110 | Jan 1, 2026 | $60,369 | $3,022 |
| VISION SERVICE PLAN | Vision | 109 | Jan 1, 2026 | $8,880 | $695 |
| CANOPY | — | 132 | Jan 1, 2026 | $3,600 | $0 |
Premium and claims on this contract
DELTA DENTAL OF WASHINGTON, contract 13105. For the contract year on this filing, the carrier reported $60,369 in premium earned and $33,443 in claims incurred. Dividing one by the other gives 55%.
- DELTA DENTAL OF WASHINGTON, contract 13105 reported $11,108 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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