| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: KIBBLE AND PRENTICE HOLDING COMPANY | 601 UNION STREET, SUITE 1000 SEATTLE, WA 98101 | BLUECROSS BLUESHIELD OF ILLINOIS | $28K | — | $28K | 4.02% |
| BAUGHMAN GROUP3 Filed as: BAUGHMAN GROUP INC. | UNKNOWN BELLEVUE, WA 98004 | BLUECROSS BLUESHIELD OF ILLINOIS | $4K | — | $4K | 0.59% |
| USI INSURANCE SERVICES LLC3 Filed as: KIBBLE AND PRENTICE HOLDING COMPANY | 601 UNION STREET, SUITE 1000 SEATTLE, WA 98101 | CALIFORNIA PHYSICIANS SERVICE | $14K | — | $14K | 3.53% |
| USI INSURANCE SERVICES LLC3 Filed as: KIBBLE AND PRENTICE HOLDING COMPANY | 601 UNION STREET, SUITE 1000 SEATTLE, WA 98101 | HEALTHPARTNERS, INC. | — | $6K | $6K | 2.68% |
| USI INSURANCE SERVICES LLC3 Filed as: KIBBLE AND PRENTICE HOLDING COMPANY | 601 UNION STREET, SUITE 1000 SEATTLE, WA 98101 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $12K | $6K | $18K | 9.26% |
| USI INSURANCE SERVICES LLC3 Filed as: KIBBLE AND PRENTICE HOLDING COMPANY | 601 UNION STREET, SUITE 1000 SEATTLE, WA 98101 | DELTA DENTAL OF WASHINGTON | $15K | — | $15K | 8.59% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN AND BROWN OF KENTUCKY, INC. | 13101 MAGISTERIAL DRIVE, SUITE 200 LOUISVILLE, KY 40223 | ANTHEM HEALTH PLANS OF KENTUCKY, INC. | $3K | — | $3K | 1.74% |
| MEDLINK INC3 Filed as: MEDLINK, INC. | 2001 LAKE POINT WAY LOUISVILLE, KY 40223 | ANTHEM HEALTH PLANS OF KENTUCKY, INC. | $1K | — | $1K | 0.76% |
| USI INSURANCE SERVICES LLC3 Filed as: KIBBLE AND PRENTICE HOLDING COMPANY | 601 UNION STREET, SUITE 1000 SEATTLE, WA 98101 | VISION SERVICE PLAN | $1K | — | $1K | 5.02% |
| USI INSURANCE SERVICES LLC3 Filed as: KIBBLE AND PRENTICE HOLDING COMPANY | 601 UNION STREET, SUITE 1000 SEATTLE, WA 98101 | SUPERIOR DENTAL CARE, INC. | $836 | — | $836 | 9.07% |
No Schedule C service providers reported on this filing.
Benefits declared on the Form 5500 main form (✓ = also has a Schedule A insurance contract; otherwise the benefit is funded out of plan assets or via a Schedule C TPA).
The plan reports several different headcounts depending on which form you read. Each one measures a different slice of the population.
| Active participants | 449 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 449 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 4 carriers) | BLUECROSS BLUESHIELD OF ILLINOIS | 98 | $1.5M |
| Dental(2 contracts, 2 carriers) | DELTA DENTAL OF WASHINGTON | 390 | $183K |
| Vision | VISION SERVICE PLAN | 159 | $25K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 449 | $194K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 449 | $194K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 449 | $194K |
| Prescription drug(4 contracts, 4 carriers) | BLUECROSS BLUESHIELD OF ILLINOIS | 98 | $1.5M |
| Other | LIFE INSURANCE COMPANY OF NORTH AMERICA | 449 | $194K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 449 | — |
Why the numbers differ. Form 5500 line 6 counts employees + retirees + beneficiaries; no dependents. Schedule A persons-covered counts everyone enrolled, including spouses and children, so it usually exceeds line 6 by 30-60% on a working-age workforce. The medical row is normally the broadest single line because it has the highest take-up; dental/vision/life often dip below it. Stop-loss / reinsurance contracts sometimes report the carrier's full underwriting pool rather than this filer's headcount; the row is shown for transparency but shouldn't be read as "people in this plan."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.