Form 5500 · Employee benefit plan · SEATTLE, WA
PLYMOUTH HOUSING GROUP
The filing calls this plan PLYMOUTH HOUSING GROUP HEALTH & WELFARE PLAN.
PLYMOUTH HOUSING GROUP of SEATTLE, WA files a Form 5500 with the U.S. Department of Labor disclosing its employee benefit plan. Its broker of record is USI INSURANCE SERVICES, LLC. Coverage is written through KAISER FOUNDATION HEALTH PLAN OF WASHINGTON OPTIONS, INC. and 6 other carriers. The plan's most recent policy period ended in October.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 91-1122621 · plan 501 · plan year 2025, filed May 6, 2026
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48 other employer plans in Washington have policy years ending in October. 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.
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 7 insured contracts covering health, dental, vision, life and disability; the largest, with KAISER FOUNDATION HEALTH PLAN OF WASHINGTON OPTIONS, INC., covers 279 people.
Reported premium across the insured contracts is $3,187,660, with $149,975 in disclosed broker commissions — about 4.7% of premium.
The health contract's policy period ended in October, while at least one ancillary line's policy period ended in November. The plan is on a split renewal cycle.
USI INSURANCE SERVICES, LLC is the broker of record on 3 of the 7 contracts; the rest name a different broker or none.
7 carriers appear on the filing, including KAISER FOUNDATION HEALTH PLAN OF WASHINGTON OPTIONS, INC., KAISER FOUNDATION HEALTH PLAN OF WASHINGTON, DELTA DENTAL OF WASHINGTON and SYMETRA LIFE INSURANCE COMPANY. KAISER FOUNDATION HEALTH PLAN OF WASHINGTON OPTIONS, INC. writes the largest contract by premium.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| KAISER FOUNDATION HEALTH PLAN OF WASHINGTON OPTIONS, INC. | Health | 279 | Nov 1, 2025 | $1,942,611 | $74,950 |
| KAISER FOUNDATION HEALTH PLAN OF WASHINGTON | Health | 139 | Nov 1, 2025 | $800,997 | $35,141 |
| SYMETRA LIFE INSURANCE COMPANY | Life, Disability | 389 | Nov 1, 2025 | $104,788 | $23,877 |
| DELTA DENTAL OF WASHINGTON | Dental | 470 | Nov 1, 2025 | $286,523 | $14,377 |
| VISION SERVICE PLAN | Vision | 344 | Nov 1, 2025 | $27,157 | $1,630 |
| CURALINC LLC | — | 410 | Nov 1, 2025 | $23,452 | $0 |
| WELLSPRING FAMILY SERVICES EAP | — | 410 | Dec 1, 2024 | $2,132 | $0 |
Premium and claims on this contract
DELTA DENTAL OF WASHINGTON, contract 6664. For the contract year on this filing, the carrier reported $286,523 in premium earned and $224,136 in claims incurred. Dividing one by the other gives 78%.
- DELTA DENTAL OF WASHINGTON, contract 6664 reported $65,900 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: 491 employees, 18 recordable cases, 811 days away from work.
Source: OSHA Injury Tracking Application establishment data, 2025.
Other plans filed by this employer
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