| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: KIBBLE & PRENTICE HOLDING COMPANY | 601 UNION ST, STE 1000 SEATTLE, WA 98101 | REGENCE BLUE SHIELD | $174K | $103 | $174K | 4.31% |
| USI INSURANCE SERVICES LLC3 Filed as: KIBBLE & PRENTICE HOLDING COMPANY | PO BOX 62949 VIRGINIA BEACH, VA 23466 | KAISER FOUNDATION HEALTH PLAN INC | $22K | — | $22K | 5.05% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 6701 CENTER DRIVE WEST, SUITE 1500 LOS ANGELES, CA 90045 | KAISER FOUNDATION HEALTH PLAN INC | $1K | — | $1K | 0.34% |
| USI INSURANCE SERVICES LLC3 | 5901 PRIESTLY DR, STE 306 CARLSBAD, CA 92008 | MEDIEXCEL HEALTH PLAN | $4K | — | $4K | 3.92% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 6701 CENTER DRIVE WEST, SUITE 1500 LOS ANGELES, CA 90045 | MEDIEXCEL HEALTH PLAN | $668 | — | $668 | 0.68% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 6701 CENTER DRIVE WEST, SUITE 1500 LOS ANGELES, CA 90045 | METROPOLITAN LIFE INSURANCE COMPANY | $8K | $902 | $9K | 9.83% |
| USI INSURANCE SERVICES LLC3 Filed as: KIBBLE & PRENTICE HOLDING COMPANY | PO BOX 62949 VIRGINIA BEACH, VA 23466 | EYEMED | $840 | — | $840 | 2.09% |
| USI INSURANCE SERVICES LLC3 Filed as: USI NW DBA KIBBLE & PRENTICE | 601 UNION ST, SUITE 1000 SEATTLE, WA 98101 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4K | $360 | $4K | 13.35% |
| EOI SERVICE COMPANY INC3 | 1820 E FIRST STREET, SUITE 400 SANTA ANA, CA 92705 | METROPOLITAN LIFE INSURANCE COMPANY | $4K | $240 | $4K | 16.62% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 6701 CENTER DRIVE WEST, SUITE 1500 LOS ANGELES, CA 90045 | METROPOLITAN LIFE INSURANCE COMPANY | — | $54 | $54 | 0.22% |
| EOI SERVICE COMPANY INC3 | 1820 E FIRST STREET, SUITE 400 SANTA ANA, CA 92705 | METROPOLITAN LIFE INSURANCE COMPANY | $5K | $299 | $5K | 74.22% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 6701 CENTER DRIVE WEST, SUITE 1500 LOS ANGELES, CA 90045 | METROPOLITAN LIFE INSURANCE COMPANY | — | $54 | $54 | 0.76% |
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 | 1,810 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 1,810 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | REGENCE BLUE SHIELD | 588 | $4.6M |
| Vision | EYEMED | 835 | $40K |
| Life insurance(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 1,843 | $118K |
| Short-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 13 | $25K |
| Long-term disability(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 1,843 | $118K |
| Prescription drug(3 contracts, 3 carriers) | REGENCE BLUE SHIELD | 588 | $4.6M |
| Other(3 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 1,843 | $125K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,843 | — |
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."
No prospect flags tripped on this filing.