| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NORTHWEST | 601 UNION STREET, SUITE 1000 SEATTLE, WA 98101 | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | $0 | $70 | $70 | 0.01% |
| PROFESSIONAL BENEFIT CONSULTANTS3 | 7525 SE 24TH STREET, SUITE 350 MERCER ISLAND, WA 98040 | STANDARD INSURANCE COMPANY | $17K | $9K | $26K | 4.54% |
| TRULUMA3 Filed as: TRULUMA, INC. | 38 AUSTIN STREET WORCESTER, MA 01609 | STANDARD INSURANCE COMPANY | $16K | $0 | $16K | 2.90% |
| MILES A. CRAIGWELL3 | 1301 4TH AVENUE, UNIT 909 SEATTLE, WA 98101 | STANDARD INSURANCE COMPANY | $5K | $0 | $5K | 0.92% |
| SERVCO INSURANCE SERVICES CORP3 Filed as: SERVCO PACIFIC INSURANCE | 1100 DEXTER AVENUE NORTH, SUITE 200 SEATTLE, WA 98019 | STANDARD INSURANCE COMPANY | $4K | $0 | $4K | 0.78% |
| MEGAN TAY3 Filed as: MEGAN E. TAY | 1702 NORTH 34TH STREET SETTLE, WA 98103 | STANDARD INSURANCE COMPANY | $4K | $0 | $4K | 0.65% |
| DIANA L. SMITH3 | 24667 SE 36TH COURT ISSAQUAH, WA 98029 | STANDARD INSURANCE COMPANY | $636 | $0 | $636 | 0.11% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62949 VIRGINIA BEACH, VA 23466 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $8 | $8 | — |
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 | 384 | 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) | 384 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON OPTIONS, INC. | 274 | $3.8M |
| Dental | DELTA DENTAL OF WASHINGTON | 611 | $390K |
| Life insurance | STANDARD INSURANCE COMPANY | 384 | $566K |
| Long-term disability | STANDARD INSURANCE COMPANY | 384 | $566K |
| Prescription drug(3 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON OPTIONS, INC. | 274 | $3.8M |
| Other(2 contracts, 2 carriers) | STANDARD INSURANCE COMPANY | 384 | $566K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 611 | — |
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.