| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NORTHWEST | 601 UNION STREET, SUITE 1000 SEATTLE, WA 98101 | PREMERA BLUE CROSS | $0 | $3K | $3K | 0.36% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62949 VIRGINIA BEACH, VA 23466 | STANDARD INSURANCE COMPANY | $0 | $3K | $3K | 5.02% |
| MASTERCARE SOLUTIONS, INC.3 | 19085 PINEHURST ROAD BEND, OR 97703 | METROPOLITAN LIFE INSURANCE COMPANY | $430 | $0 | $430 | 4.00% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62949 VIRGINIA BEACH, VA 23466 | METROPOLITAN LIFE INSURANCE COMPANY | $108 | $0 | $108 | 1.00% |
| M FINANCIAL HOLDINGS INC3 Filed as: M. FINANCIAL HOLDINGS, INC. | 1125 NW COUCH STREET, SUITE 900 PORTLAND, OR 97209 | METROPOLITAN LIFE INSURANCE COMPANY | $108 | $0 | $108 | 1.00% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NORTHWEST | 601 UNION STREET, SUITE 1000 SEATTLE, WA 98101 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | -$3 | -$3 | -0.05% |
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 | 159 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 6 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 165 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | PREMERA BLUE CROSS | 220 | $911K |
| Dental | DELTA DENTAL OF WASHINGTON | 229 | $118K |
| Vision | VISION SERVICE PLAN | 158 | $12K |
| Life insurance(2 contracts, 2 carriers) | STANDARD INSURANCE COMPANY | 157 | $66K |
| Short-term disability(2 contracts, 2 carriers) | STANDARD INSURANCE COMPANY | 157 | $66K |
| Long-term disability(2 contracts, 2 carriers) | STANDARD INSURANCE COMPANY | 157 | $66K |
| Prescription drug | PREMERA BLUE CROSS | 220 | $911K |
| Other(3 contracts, 3 carriers) | STANDARD INSURANCE COMPANY | 157 | $76K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 229 | — |
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.
Broker comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.