Form 5500 · Employee benefit plan · FIFE, WA
PUYALLUP TRIBAL GAMING ENTERPRISES, INC.
The filing calls this plan EMERALD QUEEN HOTEL & CASINOS WELFARE BENEFITS PLAN.
PUYALLUP TRIBAL GAMING ENTERPRISES, INC. of FIFE, WA files a Form 5500 with the U.S. Department of Labor disclosing its employee benefit plan. Its broker of record is GREGORY HINE. Coverage is written through PREMERA BLUE CROSS and 6 other carriers. The plan's most recent policy period ended in September.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 91-1734931 · plan 507 · plan year 2025, filed Feb 27, 2026
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114 other employer plans in Washington have policy years ending in September. 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
Disability: COLONIAL LIFE & ACCIDENT INSURANCE COMPANY covers 174 of 2,233 participants (7.8%) on Schedule A.
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 PREMERA BLUE CROSS, covers 2,036 people.
Reported premium across the insured contracts is $28,067,431, with $74,215 in disclosed broker commissions — about 0.3% of premium.
The most recent policy period ended in September, and the plan year ends September 30. Group contracts typically renew on that annual cycle.
GREGORY HINE is the broker of record on 1 of the 7 contracts; the rest name a different broker or none.
7 carriers appear on the filing, including PREMERA BLUE CROSS, WILLAMETTE DENTAL OF WASHINGTON, INC., SYMETRA LIFE INSURANCE COMPANY and COLONIAL LIFE & ACCIDENT INSURANCE COMPANY. PREMERA BLUE CROSS writes the largest contract by premium.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | Disability | 174 | Oct 1, 2025 | $258,640 | $34,282 |
| SYMETRA LIFE INSURANCE COMPANY | Life | 1,875 | Oct 1, 2025 | $305,739 | $32,398 |
| UNUM LIFE INSURANCE COMPANY OF AMERICA | Life | 38 | Oct 1, 2025 | $143,193 | $7,535 |
| PREMERA BLUE CROSS | Health, Dental | 2,036 | Oct 1, 2025 | $26,356,731 | $0 |
| WILLAMETTE DENTAL OF WASHINGTON, INC. | Dental | 1,197 | Oct 1, 2025 | $748,251 | $0 |
| VISION SERVICE PLAN | Vision | 3,122 | Oct 1, 2025 | $212,098 | $0 |
| CURALINC LLC | — | 1,992 | Oct 1, 2025 | $42,779 | $0 |
Premium and claims on this contract
WILLAMETTE DENTAL OF WASHINGTON, INC., contract WA155. For the contract year on this filing, the carrier reported $748,251 in premium earned and $590,768 in claims incurred. Dividing one by the other gives 79%.
- WILLAMETTE DENTAL OF WASHINGTON, INC., contract WA155 reported $69,213 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
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