| 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 WASHINGTON OPTIONS, INC. | $20K | $0 | $20K | 4.44% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NORTHWEST | 601 UNION STREET, SUITE 1000 SEATTLE, WA 98101 | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON | $6K | $0 | $6K | 4.51% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62949 VIRGINIA BEACH, VA 23466 | STANDARD INSURANCE COMPANY | $6K | $0 | $6K | 9.37% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN AND BROWN OF NY, INC. | 595 STEWART AVENUE, SUITE 700 GARDEN CITY, NY 11530 | STANDARD INSURANCE COMPANY | $0 | $956 | $956 | 1.52% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NORTHWEST | 601 UNION STREET, SUITE 1000 SEATTLE, WA 98101 | WILLAMETTE DENTAL OF WASHINGTON, INC. | $3K | $0 | $3K | 10.00% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62949 VIRGINIA BEACH, VA 23466 | VISION SERVICE PLAN | $727 | $0 | $727 | 7.05% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN AND BROWN OF WASHINGTON | 800 5TH AVENUE, SUITE 2400 SEATTLE, WA 98104 | VISION SERVICE PLAN | $218 | $0 | $218 | 2.11% |
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 | 122 | 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) | 122 | 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. | 99 | $572K |
| Dental(2 contracts, 2 carriers) | STANDARD INSURANCE COMPANY | 122 | $92K |
| Vision | VISION SERVICE PLAN | 102 | $10K |
| Life insurance | STANDARD INSURANCE COMPANY | 122 | $63K |
| Prescription drug(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON OPTIONS, INC. | 99 | $572K |
| Other | STANDARD INSURANCE COMPANY | 122 | $63K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 122 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.