| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: KIBBLE & PRENTICE HOLDING COMP | 200 SUMMIT LAKE DRIVE SUITE 350 VALHALLA, NY 10595 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $23K | — | $23K | 20.00% |
| MARSH & MCLENNAN AGENCY LLC3 | PO BOX 4386 MISSOULA, MT 59806 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $7 | $1K | 3.34% |
| CHRISTOPHER ROBERT BERRY3 | 27108 162ND ST SE MONROE, WA 98272 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $694 | $169 | $863 | 1.97% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: PAYNEWEST INSURANCE INC | 145 W FRONT ST MISSOULA, MT 59801 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $800 | — | $800 | 1.83% |
| VALORIE L STRICKLAND3 | 1437 CIMARRON PL RICHLAND, WA 99352 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $588 | $2 | $590 | 1.35% |
| JESSICA LOREE GROW3 | 10 S VANCOUVER ST KENNEWICK, WA 99336 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $217 | $2 | $219 | 0.50% |
| RICH IN BENEFITS INC3 | 13109 NE 123RD ST KIRKLAND, WA 98034 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $175 | — | $175 | 0.40% |
| HEARTSEASE LLC3 | 1521 NE 63RD AVENUE HILLSBORO, OR 97124 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $73 | — | $73 | 0.17% |
| RYAN G YOUNG3 | 801 N NURSERY RD IRVING, TX 75061 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $66 | — | $66 | 0.15% |
| TERESA FELLER3 | 3405 172ND STREET NE, #5 ARLINGTON, WA 98223 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $38 | — | $38 | 0.09% |
| CHRISTINE LYNN MORGESTER3 | 14913 S SUNTERRA LOOP OREGON CITY, OR 97045 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $37 | — | $37 | 0.08% |
| BENEFITS BY DESIGN INC3 | 2101 NE 279TH ST RIDGEFIELD, WA 98642 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $28 | — | $28 | 0.06% |
| WORKSITE BENEFITS GROUP INC3 Filed as: WORKSITE BENEFITS GROUP INC. | 112 NW 114TH ST VANCOUVER, WA 98685 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $25 | — | $25 | 0.06% |
| DONALD C SAVOY INC3 Filed as: DONALD TERRY GOTHAM | 3129 ECLIPSE DR. GREEN BAY, WI 54311 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $12 | — | $12 | 0.03% |
| USI INSURANCE SERVICES LLC3 Filed as: KIBBLE & PRENTICE HOLDING CO | PO BOX 62949 VIRGINIA BEACH, VA 23466 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $2K | — | $2K | 15.00% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES | PO BOX 62889 VIRGINIA BEACH, VA 23466 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $339 | $339 | 2.16% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62889 VIRGINIA BEACH, VA 23466 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $275 | $275 | 1.96% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: PAYNEWEST INSURANCE | 390 BRADLEY BOULEVARD RICHLAND, WA 99352 | CINCINNATI LIFE INSURANCE COMPANY | $52 | — | $52 | 1.99% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: PAYNEWEST INSURANCE | 390 BRADLEY BOULEVARD RICHLAND, WA 99352 | CINCINNATI LIFE INSURANCE COMPANY | $33 | — | $33 | 1.98% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BENEFIT ADMINISTRATIVE SYSTEMS, LLC EIN 36-4197088 PLAN ADMINISTRATOR | Contract Administrator Service code 13 | 18861 90TH AVENUE SUITE A MOKENA, IL 60448 | $141K |
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 | 270 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 272 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 190 | $116K |
| Vision | VISION SERVICE PLAN | 184 | $19K |
| Life insurance(2 contracts) | CINCINNATI LIFE INSURANCE COMPANY | 5 | $4K |
| Short-term disability | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 35 | $44K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 36 | $14K |
| Other(2 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 50 | $59K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 190 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.