Form 5500 · Employee benefit plan · BELLEVUE, WA
T-MOBILE USA, INC.
The filing calls this plan T-MOBILE USA, INC. EMPLOYEE BENEFIT PLAN.
T-MOBILE USA, INC. of BELLEVUE, WA spreads its employee benefits across 4 insurance carriers, according to its Form 5500 Schedule A. Its broker of record is AMERICAN BENEFITS & COMP SYSTEMS. Coverage is written through HARTFORD LIFE AND ACCIDENT and 3 other carriers. The plan's most recent policy period ended in December.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 91-1983600 · plan 506 · plan year 2024, filed Oct 6, 2025
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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
Both, as reported
The medical insurance contracts on the filing cover fewer than half the people in the plan, so the rest is paid another way.
A stop-loss policy appears on a Form 5500 only when the plan itself is the beneficiary, or the premiums are paid from plan money. Many employers buy stop-loss and never report it here. So a plan with no stop-loss on its filing may still have it.
Benefits declared on this filing
Health: HAWAII MEDICAL SERVICE ASSOCIATION covers 436 of 70,635 participants (0.6%) on Schedule A.
3 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 health, life and disability; the largest, with HARTFORD LIFE AND ACCIDENT, covers 92,108 people.
The filing declares health, life, disability, dental and vision. Dental and vision appear 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 3 contracts here that do not say what they cover.
Reported premium across the insured contracts is $45,044,295, with $9,902 in disclosed broker commissions — about 0% 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.
AMERICAN BENEFITS & COMP SYSTEMS is the broker of record on 3 of the 5 contracts; the rest name a different broker or none.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| HARTFORD FIRE INSURANCE COMPANY | — | 74,331 | Jan 1, 2025 | $99,016 | $9,902 |
| HARTFORD LIFE AND ACCIDENT | Life, Disability | 92,108 | Jan 1, 2025 | $31,755,099 | $0 |
| UNITED BEHAVIORAL HEALTH DBA OPTUM | — | 69,466 | Jan 1, 2025 | $8,037,735 | $0 |
| HAWAII MEDICAL SERVICE ASSOCIATION | Health | 436 | Jan 1, 2025 | $2,962,231 | $0 |
| HARTFORD LIFE AND ACCIDENT | — | 85,572 | Jan 1, 2025 | $2,190,214 | $0 |
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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Renewal calendar
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