| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: KIBBLE & PRENTICE HOLDING | 601 UNION STREET STE 1000 SEATTLE, WA 98101 | PREMERA BLUE CROSS | $16K | — | $16K | 1.09% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | PO BOX 5668 CONCORD, CA 94524 | PREMERA BLUE CROSS | $15K | — | $15K | 1.02% |
| USI INSURANCE SERVICES LLC3 Filed as: KIBBLE & PRENTICE HOLDING COMPANY | D/B/A USI INSURANCE SERVICE PO BOX 62949 VIRGINIA BEACH, VA 234662949 | METROPOLITAN LIFE INSURANCE COMPANY | $3K | $996 | $4K | 12.42% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | 1390 WILLOW PASS RD STE 800 CONCORD, CA 945207924 | METROPOLITAN LIFE INSURANCE COMPANY | $2K | $159 | $2K | 5.27% |
| USI INSURANCE SERVICES LLC3 Filed as: KIBBLE & PRENTICE HOLDING COMPANY | PO BOX 62949 VIRGINIA BEACH, VA 234662949 | VISION SERVICE PLAN | $636 | — | $636 | 4.26% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | PO BOX 101809 PASADENA, CA 91189 | VISION SERVICE PLAN | $290 | — | $290 | 1.94% |
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 | 171 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 171 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | PREMERA BLUE CROSS | 149 | $1.5M |
| Dental | PREMERA BLUE CROSS | 149 | $1.5M |
| Vision | VISION SERVICE PLAN | 99 | $15K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 215 | $34K |
| Short-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 215 | $34K |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 215 | $34K |
| Prescription drug | PREMERA BLUE CROSS | 149 | $1.5M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 215 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.