| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: KIBBLE & PRENTICE HOLDING | 601 UNION STREET SEATTLE, WA 98101 | AETNA LIFE INSURANCE CO. | $41K | $15K | $56K | 1.87% |
| HEFFERNAN INSURANCE BROKERS3 | 1350 CARLBACK AVE., SUITE 200 WALNUT CREEK, CA 94596 | AETNA LIFE INSURANCE CO. | $21K | — | $21K | 0.70% |
| HEFFERNAN INSURANCE BROKERS3 | 1350 CARLBACK AVE., SUITE 200 WALNUT CREEK, CA 94596 | DELTA DENTAL OF WASHINGTON | $15K | — | $15K | 7.53% |
| USI INSURANCE SERVICES LLC3 Filed as: KIBBLE & PRENTICE INC | PO BOX 62949 VIRGINIA BEACH, VA 23466 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $2K | $5K | 10.88% |
| HEFFERNAN INSURANCE BROKERS3 | 1350 CARLBACK AVE., SUITE 200 WALNUT CREEK, CA 94596 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | — | $4K | 8.42% |
| USI INSURANCE SERVICES LLC3 Filed as: KIBBLE & PRENTICE | PO BOX 62949 VIRGINIA BEACH, VA 23466 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $1K | $3K | 9.76% |
| HEFFERNAN INSURANCE BROKERS3 | 1350 CARLBACK AVE., SUITE 200 WALNUT CREEK, CA 94596 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | — | $3K | 8.29% |
| USI INSURANCE SERVICES LLC3 Filed as: KIBBLE & PRENTICE INC | PO BOX 62949 VIRGINIA BEACH, VA 23466 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $1K | $3K | 9.03% |
| HEFFERNAN INSURANCE BROKERS3 | 1350 CARLBACK AVE., SUITE 200 WALNUT CREEK, CA 94596 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 5.26% |
| HEFFERNAN INSURANCE BROKERS3 | 1350 CARLBACK AVE., SUITE 200 WALNUT CREEK, CA 94596 | VISION SERVICE PLAN | $922 | — | $922 | 3.41% |
| USI INSURANCE SERVICES LLC3 Filed as: KIBBLE & PRENTICE | PO BOX 62949 VIRGINIA BEACH, VA 23466 | VISION SERVICE PLAN | $812 | — | $812 | 3.01% |
| USI INSURANCE SERVICES LLC3 Filed as: KIBBLE & PRENTICE INC | PO BOX 62949 VIRGINIA BEACH, VA 23466 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $1K | $2K | 9.22% |
| HEFFERNAN INSURANCE BROKERS3 | 1350 CARLBACK AVE., SUITE 200 WALNUT CREEK, CA 94596 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | — | $1K | 5.36% |
| USI INSURANCE SERVICES LLC3 Filed as: KIBBLE & PRENTICE INC | PO BOX 62949 VIRGINIA BEACH, VA 23466 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $198 | $134 | $332 | 11.21% |
| HEFFERNAN INSURANCE BROKERS3 | 1350 CARLBACK AVE., SUITE 200 WALNUT CREEK, CA 94596 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $246 | — | $246 | 8.31% |
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 | 0 | 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) | 0 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | AETNA LIFE INSURANCE CO. | 430 | $3.0M |
| Dental | DELTA DENTAL OF WASHINGTON | 220 | $200K |
| Vision | VISION SERVICE PLAN | 221 | $27K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 223 | $50K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 223 | $33K |
| Prescription drug | AETNA LIFE INSURANCE CO. | 430 | $3.0M |
| Other(4 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 223 | $108K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 430 | — |
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.
Final-filing indicator set. Plan is winding down; don't waste sales effort here.