| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: KIBBLE & PRENTICE HOLDING CO | 601 UNION ST STE 1000 SEATTLE, WA 98101 | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON OPTIONS, INC | $30K | — | $30K | 3.20% |
| WOODRUFF-SAWYER & CO3 | 50 CALIFORNIA STREET, FLOOR 12 SAN FRANCISCO, CA 94111 | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON OPTIONS, INC | $876 | — | $876 | 0.09% |
| USI INSURANCE SERVICES LLC3 Filed as: KIBBLE & PRENTICE HOLDING CO | PO BOX 62949 VIRGINIA BEACH, VA 23466 | METROPOLITAN LIFE INSURANCE COMPANY | $4K | $4K | $8K | 8.58% |
| WOODRUFF-SAWYER & CO3 | 1001 SW 5TH AVE STE 1000 PORTLAND, OR 97204 | METROPOLITAN LIFE INSURANCE COMPANY | $786 | $57 | $843 | 0.86% |
| WOODRUFF-SAWYER & CO3 | 50 CALIFORNIA STREET, FLOOR 12 SAN FRANCISCO, CA 94111 | METROPOLITAN LIFE INSURANCE COMPANY | — | $196 | $196 | 0.20% |
| PLANSOURCE BENEFITS ADMINISTRATION3 | 101 S GARLAND AVE STE 203 101 ORLANDO, FL 32801 | METROPOLITAN LIFE INSURANCE COMPANY | — | $6 | $6 | 0.01% |
| USI INSURANCE SERVICES LLC3 Filed as: KIBBLE & PRENTICE HOLDING CO | PO BOX 62949 VIRGINIA BEACH, VA 23466 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $9K | — | $9K | 9.07% |
| USI INSURANCE SERVICES LLC3 | PO BOX 66199 VIRGINIA BEACH, VA 23466 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $2K | $2K | 2.50% |
| COMPSYCH5 | 455 N CITYFRONT PLZ DR 13TH FLOOR CHICAGO, IL 60611 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $1K | $1K | 1.14% |
| WOODRUFF-SAWYER & CO3 Filed as: WOODRUFF SAWYER & CO | 50 CALIFORNIA STREET, FLOOR 12 SAN FRANCISCO, CA 94111 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $615 | — | $615 | 0.66% |
| IMG5 | 2960 NORTH MERIDIAN STREET INDIANAPOLIS, IN 46208 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $27 | $27 | 0.03% |
| USI INSURANCE SERVICES LLC3 Filed as: KIBBLE & PRENTICE HOLDING CO | 601 UNION ST STE 1000 SEATTLE, WA 98101 | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON | $3K | — | $3K | 3.32% |
| WOODRUFF-SAWYER & CO3 | 50 CALIFORNIA STREET, FLOOR 12 SAN FRANCISCO, CA 94111 | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON | $94 | — | $94 | 0.11% |
| USI INSURANCE SERVICES LLC3 Filed as: KIBBLE & PRENTICE HOLDING CO | PO BOX 62949 VIRGINIA BEACH, VA 23466 | VISION SERVICE PLAN | $745 | — | $745 | 7.49% |
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 | 127 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 6 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 133 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON OPTIONS, INC | 147 | $1.0M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 252 | $99K |
| Vision | VISION SERVICE PLAN | 93 | $10K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 151 | $94K |
| Short-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 151 | $94K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 151 | $94K |
| Prescription drug(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON OPTIONS, INC | 147 | $1.0M |
| Other | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 151 | $94K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 252 | — |
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."
No prospect flags tripped on this filing.