| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | PO BOX 62949 VIRGINIA BEACH, VA 23466 | KAISER FOUNDATION HEALTH PLAN INC | $31K | $0 | $31K | 1.43% |
| 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 | $28K | $166 | $28K | 2.18% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62949 VIRGINIA BEACH, VA 23466 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $75K | $15K | $90K | 9.00% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NORTHWEST | 601 UNION STREET, SUITE 1000 SEATTLE, WA 98101 | OREGON DENTAL SERVICE DBA DELTA DENTAL PLAN OF OREGON | $41K | $0 | $41K | 4.25% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NORTHWEST | 601 UNION STREET, SUITE 1000 SEATTLE, WA 98101 | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON | $18K | $0 | $18K | 2.17% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62949 VIRGINIA BEACH, VA 23466 | CONTINENTAL AMERICAN INSURANCE COMPANY | $43K | $0 | $43K | 12.41% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62949 VIRGINIA BEACH, VA 23466 | VISION SERVICE PLAN | $4K | $0 | $4K | 2.27% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62949 VIRGINIA BEACH, VA 23466 | KAISER FOUNDATION HEALTH PLAN OF COLORADO | $3K | $0 | $3K | 2.10% |
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 | 1,149 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 25 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,174 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 4 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 222 | $4.4M |
| Dental | OREGON DENTAL SERVICE DBA DELTA DENTAL PLAN OF OREGON | 2,002 | $959K |
| Vision | VISION SERVICE PLAN | 956 | $166K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,149 | $1.0M |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,149 | $1.0M |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,149 | $1.0M |
| Prescription drug(4 contracts, 4 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 222 | $4.4M |
| Other(3 contracts, 3 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,149 | $1.4M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,002 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.