Form 5500 · Employee benefit plan · TUMWATER, WA
PEPSI NORTHWEST BEVERAGES LLC
The filing calls this plan PEPSI NORTHWEST BEVERAGES LLC WELFARE BENEFITS PLAN.
PEPSI NORTHWEST BEVERAGES LLC of TUMWATER, WA spreads its employee benefits across 5 insurance carriers, according to its Form 5500 Schedule A. Its broker of record is THE BALDWIN GROUP, LLC. Coverage is written through PREMERA BLUE CROSS and 4 other carriers. The plan's most recent policy period ended in December.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 20-4737891 · plan 501 · plan year 2025, filed Jul 14, 2026
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1,162 other employer plans in Washington have policy years ending in December. See the full list on the renewal calendar, or ask for it in Claude or ChatGPT.
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.
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 health, dental, vision, life and disability; the largest, with PREMERA BLUE CROSS, covers 675 people.
Reported premium across the insured contracts is $6,421,175, with $12,940 in disclosed broker commissions — about 0.2% 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.
THE BALDWIN GROUP, LLC is the broker of record on 2 of the 5 contracts; the rest name a different broker or none.
5 carriers appear on the filing, including PREMERA BLUE CROSS, DELTA DENTAL OF WASHINGTON, PRINCIPAL LIFE INSURANCE COMPANY and VISION SERVICE PLAN. PREMERA BLUE CROSS writes the largest contract by premium.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| PRINCIPAL LIFE INSURANCE COMPANY | Life, Disability | 405 | Jan 1, 2026 | $219,560 | $12,940 |
| PREMERA BLUE CROSS | Health | 675 | Jan 1, 2026 | $5,796,887 | $0 |
| DELTA DENTAL OF WASHINGTON | Dental | 682 | Jan 1, 2026 | $353,449 | $0 |
| VISION SERVICE PLAN | Vision | 333 | Jan 1, 2026 | $44,051 | $0 |
| COMPSYCH CORPORATION | — | 350 | Jan 1, 2026 | $7,228 | $0 |
Premium and claims on this contract
DELTA DENTAL OF WASHINGTON, contract 09399. For the contract year on this filing, the carrier reported $353,449 in premium earned and $284,164 in claims incurred. Dividing one by the other gives 80%.
- DELTA DENTAL OF WASHINGTON, contract 09399 reported $57,612 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.
Reported to OSHA
Reported to OSHA for 2025: 341 employees, 8 recordable cases, 199 days away from work.
Source: OSHA Injury Tracking Application establishment data, 2025.
Other plans filed by this employer
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Renewal calendar
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