| 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 | REGENCE BLUECROSS BLUESHIELD OF OREGON | $137K | $26K | $163K | 1.64% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NORTHWEST | 601 UNION STREET, SUITE 1000 SEATTLE, WA 98101 | KAISER FOUNDATION HEALTH PLAN INC | $26K | $0 | $26K | 1.63% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62949 VIRGINIA BEACH, VA 23466 | KAISER FOUNDATION HEALTH PLAN INC | $5K | $0 | $5K | 0.30% |
| 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 | $20K | $0 | $20K | 1.51% |
| UNKNOWN3 | UNKNOWN PORTLAND, OR 97223 | OREGON DENTAL SERVICE DBA DELTA DENTAL PLAN OF OREGON | $46K | $0 | $46K | 5.00% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NORTHWEST | 601 UNION STREET, SUITE 1000 SEATTLE, WA 98101 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $87K | $10K | $98K | 16.79% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NORTHWEST | 825 NE MULTNOMAH STREET, SUITE 1500 PORTLAND, OR 97232 | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON | $7K | $0 | $7K | 1.46% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NORTHWEST | 825 NE MULTNOMAH STREET, SUITE 1500 PORTLAND, OR 97232 | VISION SERVICE PLAN | $4K | $0 | $4K | 2.11% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62949 VIRGINIA BEACH, VA 23466 | CONTINENTAL AMERICAN INSURANCE COMPANY | $95K | $0 | $95K | 64.69% |
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 | 1,102 | 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) | 1,102 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 4 carriers) | REGENCE BLUECROSS BLUESHIELD OF OREGON | 1,346 | $13.4M |
| Dental | OREGON DENTAL SERVICE DBA DELTA DENTAL PLAN OF OREGON | 2,052 | $911K |
| Vision | VISION SERVICE PLAN | 987 | $172K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,102 | $581K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,102 | $581K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,102 | $581K |
| Prescription drug(4 contracts, 4 carriers) | REGENCE BLUECROSS BLUESHIELD OF OREGON | 1,346 | $13.4M |
| Other(3 contracts, 3 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,157 | $746K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,052 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.