| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NORTHWEST | 825 NE MULTNOMAH STREET, SUITE 1500 PORTLAND, OR 97232 | UNITEDHEALTHCARE INSURANCE COMPANY | $104K | $0 | $104K | 5.00% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62949 VIRGINIA BEACH, VA 23466 | KAISER FOUNDATION HEALTH PLAN, INC. | $40K | $0 | $40K | 4.88% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NORTHWEST | 825 NE MULTNOMAH STREET, SUITE 1500 PORTLAND, OR 97232 | DELTA DENTAL OF WASHINGTON | $8K | — | $8K | 5.00% |
| USI INSURANCE SERVICES LLC3 | 601 UNION STREET, SUITE 1000 SEATTLE, WA 98101 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $7K | $0 | $7K | 9.45% |
| HEARTSEASE LLC3 | 1521 NE 63RD AVENUE HILLSBORO, OR 97124 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $186 | $2K | 2.73% |
| WORKSITE BENEFITS GROUP INC3 Filed as: WORKSITE BENEFITS GROUP INC. | 112 NW 114 STREET VANCOUVER, WA 98685 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $549 | $114 | $663 | 0.88% |
| BENEFITS BY DESIGN INC3 Filed as: BENEFITS BY DESIGN INC. | 2101 NE 279TH STREET RIDGEFIELD, WA 98642 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $614 | $47 | $661 | 0.88% |
| MJ INSURANCE3 Filed as: KAREN CLAY KUNKLER & VARIOUS AGENTS | 415 SE 177TH AVENYE UNIT 236 VANCOUVER, WA 98685 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $244 | $1 | $245 | 0.33% |
| DAVID KINNEY3 | 802 NEVADA DRIVE LONGVIEW, WA 98632 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $232 | $0 | $232 | 0.31% |
| ISSACSON INSURANCE AGENCY LLC3 | 1250 11TH STREET WEST LINN, OR 97068 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $165 | $2 | $167 | 0.22% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62949 VIRGINIA BEACH, VA 23466 | VISION SERVICE PLAN | $2K | — | $2K | 3.94% |
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 | 152 | 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) | 152 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | UNITEDHEALTHCARE INSURANCE COMPANY | 340 | $2.9M |
| Dental | DELTA DENTAL OF WASHINGTON | 269 | $158K |
| Vision | VISION SERVICE PLAN | 239 | $44K |
| Life insurance | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 117 | $75K |
| Short-term disability | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 117 | $75K |
| Prescription drug(2 contracts, 2 carriers) | UNITEDHEALTHCARE INSURANCE COMPANY | 340 | $2.9M |
| Other | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 117 | $75K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 340 | — |
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.