| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: KIBBLE & PRENTICE HOLDING CO | 601 UNION ST. STE 1000 SEATTLE, WA 98101 | SYMETRA LIFE INSURANCE COMPANY | — | $11K | $11K | 3.73% |
| USI INSURANCE SERVICES LLC3 Filed as: KIBBLE & PRENTICE HOLDING CO | 601 UNION ST. STE 1000 SEATTLE, WA 98101 | SYMETRA LIFE INSURANCE COMPANY | — | $3K | $3K | 3.97% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UMR EIN 39-1995276 CLAIM PROCESSOR | Claims processing Service code 12 | — | $602K |
| USI INSURANCE SERVICES LLC EIN 13-3771734 BROKER | Other commissions Service code 55 | PO BOX 62889 VIRGINIA BEACH, VA 23466 | $174K |
| VAN NOY CONSULTING GROUP CONSULTING | Consulting (general) Service code 16 | 2312 PROMETHEUS CT. HENDERSON, NV 89074 | $84K |
| AMERITAS LIFE INSURANCE CORP. EIN 47-0098400 CLAIM PROCESSOR | Claims processing Service code 12 | — | $68K |
| RX BENEFITS EIN 63-1157085 PHARMACY BENEFIT MANAGER | Float revenue; Other fees; Direct payment from the plan; Claims processing Service code 12 | — | $14K |
| ALLIED BENEFIT EIN 36-3086057 CLAIM PROCESSOR | Claims processing Service code 12 | — | $12K |
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 | 923 | 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. |
| Beneficiaries receiving benefits | 0 | Spouses or dependents with eligibility independent of the participant. |
| Total participants (= "Plan participants" tile) | 923 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | SYMETRA LIFE INSURANCE COMPANY | 923 | $304K |
| Short-term disability | SYMETRA LIFE INSURANCE COMPANY | 923 | $304K |
| Long-term disability | SYMETRA LIFE INSURANCE COMPANY | 923 | $304K |
| Stop-loss / reinsurancereinsurance | TOKIO MARINE | 923 | $512K |
| Other(2 contracts) | SYMETRA LIFE INSURANCE COMPANY | 923 | $379K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 923 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.