| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: KIBBLE & PRENTICE HOLDING CO | 601 UNIONT ST STE 1000 SEATTLE, WA 98101 | REGENCE BLUECROSS BLUESHIELD OF OREGON | $85K | — | $85K | 1.15% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS LLC | 111 SW COLUMBIA SUITE 500 PORTLAND, OR 97201 | REGENCE BLUECROSS BLUESHIELD OF OREGON | $15K | — | $15K | 0.21% |
| USI INSURANCE SERVICES LLC3 Filed as: KIBBLE & PRENTICE HOLDING CO | PO BOX 62949 VIRGINIA BEACH, VA 23466 | STANDARD INSURANCE COMPANY | $16K | — | $16K | 5.06% |
| USI INSURANCE SERVICES LLC3 Filed as: KIBBLE & PRENTICE HOLDING COMPANY | PO BOX 62949 VIRGINIA BEACH, VA 23466 | STANDARD INSURANCE COMPANY | $7K | — | $7K | 5.29% |
| USI INSURANCE SERVICES LLC3 Filed as: KIBBLE & PRENTICE HOLDING COMPANY | 975 OAK ST STE 900 EUGENE, OR 974013123 | VISION SERVICE PLAN | $2K | — | $2K | 2.63% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS LLC | 4565 PAYSPHERE CIRCLE CHICAGO, IL 606740001 | VISION SERVICE PLAN | $99 | — | $99 | 0.11% |
| MCCULLUGH, CHRISTINE M3 | 14715 NE 95TH STREET STE 200 REDMOND, WA 98052 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $16K | — | $16K | 18.79% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS LLC | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $894 | — | $894 | 1.03% |
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 | 500 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 20 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 520 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | REGENCE BLUECROSS BLUESHIELD OF OREGON | 1,258 | $7.5M |
| Vision | VISION SERVICE PLAN | 515 | $88K |
| Life insurance | STANDARD INSURANCE COMPANY | 552 | $326K |
| Long-term disability | STANDARD INSURANCE COMPANY | 552 | $140K |
| Other(3 contracts, 3 carriers) | STANDARD INSURANCE COMPANY | 552 | $424K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,258 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.