Form 5500 · Employee benefit plan · TACOMA, WA
PEDIATRICS NORTHWEST, P.S.
The filing calls this plan PEDIATRICS NORTHWEST, P. S. EMPLOYEE BENEFITS PLAN.
PEDIATRICS NORTHWEST, P.S. of TACOMA, WA insures health, vision, life and disability coverage for its employees, per Schedule A of its Form 5500. Its broker of record is BROWN & BROWN OF WASHINGTON. Coverage is written through REGENCE BLUESHIELD and 1 other carrier. The plan's most recent policy period ended in December.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 91-2089965 · plan 501 · plan year 2023, filed Jul 23, 2024
Get an email when this employer files a new Form 5500, and again about four months before its plan renews.
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.
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 2 insured contracts covering health, vision, life and disability; the largest, with REGENCE BLUESHIELD, covers 161 people.
Reported premium across the insured contracts is $1,283,868, with $72,237 in disclosed broker commissions — about 5.6% 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.
BROWN & BROWN OF WASHINGTON is the broker of record on all 2 contracts.
Two carriers split the book: REGENCE BLUESHIELD and LIFEMAP ASSURANCE COMPANY.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| REGENCE BLUESHIELD | Health | 161 | Jan 1, 2024 | $1,205,397 | $60,455 |
| LIFEMAP ASSURANCE COMPANY | Vision, Life, Disability | 107 | Jan 1, 2024 | $78,471 | $11,782 |
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
Subscribers see how this compares with similar plans in Washington. A subscription also adds this plan's filing history and the renewal calendar for its state. See plans and prices
Without an account you can open 10 employer, broker and carrier pages a day, including through an AI assistant, and 50 a day with a free account. Paid plans are what keep these records free to read.
More employer plans in Washington — largest plans, brokers, carriers and renewal months.