Form 5500 · Employee benefit plan · OLYMPIA, WA
THE TRUSTEES OF THE EMPLOYEE BENEFITS TRUST
The filing calls this plan AWB HEALTHCHOICE EMPLOYEE BENEFITS TRUST - MANUFACTURING.
THE TRUSTEES OF THE EMPLOYEE BENEFITS TRUST of OLYMPIA, WA insures health, dental, vision, life and disability coverage for its employees, per Schedule A of its Form 5500. Coverage is written through PREMERA BLUE CROSS and 5 other carriers. The plan's most recent policy period ended in December.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 61-6496436 · plan 505 · plan year 2024, filed Oct 9, 2025
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How this plan is funded
Fully insured as reported
The plan's own financial statement reports paying insurance carriers about what the insurance contracts report in premium.
The filing says this plan is subject to the Form M-1 requirement for multiple-employer welfare arrangements.
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.
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 6 insured contracts covering health, dental, vision, life and disability; the largest, with PREMERA BLUE CROSS, covers 1,814 people.
Reported premium is $15,410,191; the filing discloses no broker commission on these contracts.
The most recent policy period ended in December, and the plan year ends December 31. Group contracts typically renew on that annual cycle.
No broker of record is named on the Schedule A. The contracts may be written directly with the carrier, or the broker fields were left blank on the filing.
6 carriers appear on the filing, including PREMERA BLUE CROSS, DELTA DENTAL OF WASHINGTON, VISION SERVICE PLAN and METROPOLITAN LIFE INSURANCE COMPANY. PREMERA BLUE CROSS writes the largest contract by premium.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| PREMERA BLUE CROSS | Health | 1,814 | Jan 1, 2025 | $14,890,205 | $0 |
| DELTA DENTAL OF WASHINGTON | Dental | 480 | Jan 1, 2025 | $367,456 | $0 |
| VISION SERVICE PLAN | Vision | 1,810 | Jan 1, 2025 | $70,841 | $0 |
| METROPOLITAN LIFE INSURANCE COMPANY | Life | 1,811 | Jan 1, 2025 | $53,544 | $0 |
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | Life, Disability | 240 | Jan 1, 2025 | $20,479 | $0 |
| WILLAMETTE DENTAL OF WASHINGTON, INC. | Dental | 9 | Jan 1, 2025 | $7,666 | $0 |
Premium and claims on these contracts
DELTA DENTAL OF WASHINGTON, contract 09450-09457. For the contract year on this filing, the carrier reported $367,456 in premium earned and $275,167 in claims incurred. Dividing one by the other gives 75%.
VISION SERVICE PLAN, contract 122482630016-19. For the contract year on this filing, the carrier reported $70,841 in premium earned and $54,887 in claims incurred. Dividing one by the other gives 77%.
WILLAMETTE DENTAL OF WASHINGTON, INC., contract WA385. For the contract year on this filing, the carrier reported $7,666 in premium earned and $7,369 in claims incurred. Dividing one by the other gives 96%.
- VISION SERVICE PLAN, contract 122482630016-19 reported $13,450 in retention.
- WILLAMETTE DENTAL OF WASHINGTON, INC., contract WA385 reported $901 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
Named on Schedule C of this filing. We publish company names only.
Money the plan held and paid out
Sourced from U.S. DOL EFAST2 Form 5500 · Schedule H
These are the plan's own figures from Schedule H, the financial statement it files. They are not the premium on Schedule A.
Other plans filed by this employer
How this plan compares
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