Form 5500 · Employee benefit plan · SEATTLE, WA
MAGNUSSON KLEMENCIC ASSOCIATES, INC.
The filing calls this plan MAGNUSSON KLEMENCIC ASSOCIATES, INC. HEALTH WELFARE PLAN.
Public Form 5500 records show how MAGNUSSON KLEMENCIC ASSOCIATES, INC. of SEATTLE, WA, a professional services employer, structures its employee benefits. Its broker of record is SPECIALTY PLANNERS, INC.. Coverage is written through DELTA DENTAL OF WASHINGTON and 4 other carriers. The plan's most recent policy period ended in December.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 91-0861758 · plan 501 · plan year 2025, filed Jul 14, 2026
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How this plan is funded
Funding not settled by the filing
The filing does not report enough to settle how this plan pays for benefits.
Benefits declared on this filing
2 contracts on this filing do not say which benefits they cover, so a line above may be insured by one of them.
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.
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 dental, vision, life and disability; the largest, with DELTA DENTAL OF WASHINGTON, covers 250 people.
The filing declares dental, vision, life, disability and health. Health appears with no insured contract on Schedule A. That coverage may be self-funded, placed with a carrier that is not on this filing, or written on one of the 2 contracts here that do not say what they cover.
Reported premium across the insured contracts is $267,315, with $5,590 in disclosed broker commissions — about 2.1% 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.
SPECIALTY PLANNERS, INC. is the broker of record on 1 of the 5 contracts; the rest name a different broker or none.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| LIFESECURE INSURANCE COMPANY | — | 79 | Jan 1, 2026 | $39,164 | $4,354 |
| VISION SERVICE PLAN | Vision | 154 | Jan 1, 2026 | $17,345 | $1,011 |
| HARTFORD LIFE AND ACCIDENT | — | 156 | Jan 1, 2026 | $1,500 | $225 |
| DELTA DENTAL OF WASHINGTON | Dental | 250 | Jan 1, 2026 | $165,277 | $0 |
| UNITED OF OMAHA LIFE INSURANCE COMPANY | Life, Disability | 154 | Jan 1, 2026 | $44,029 | $0 |
Premium and claims on this contract
DELTA DENTAL OF WASHINGTON, contract 58. For the contract year on this filing, the carrier reported $165,277 in premium earned and $115,020 in claims incurred. Dividing one by the other gives 70%.
- DELTA DENTAL OF WASHINGTON, contract 58 reported $14,214 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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