| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC4 Filed as: TOWERS WATSON DELAWARE INC. | LOCKBOX 28852 PO BOX 28852 NEW YORK, NY 10087 | DELTA DENTAL OF WASHINGTON | $31K | — | $31K | 1.40% |
| WILLIS TOWERS WATSON US LLC4 Filed as: TOWERS WATSON PENNSYLVANIA INC. | P.O. BOX 8500 LOCKBOX 9102 PHILADELPHIA, PA 19178 | DELTA DENTAL OF WASHINGTON | $3K | — | $3K | 0.14% |
| USI INSURANCE SERVICES LLC3 Filed as: KIBBLE & PRENTICE HOLDING COMPANY | SUITE 100 601 UNION STREET SEATTLE, WA 981014064 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $95K | — | $95K | 7.39% |
| USI INSURANCE SERVICES LLC3 | ATTN ACCOUNTING CENTER PO BOX 3716 NORFOLK, VA 235143716 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $19K | — | $19K | 1.46% |
| AXA ASSISTANCE, USA5 | 122 SOUTH MICHIGAN AVENUE, STE 1100 CHICAGO, IL 606036115 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $448 | $448 | 0.03% |
| WILLIS TOWERS WATSON US LLC4 Filed as: TOWERS WATSON DELAWARE INC | 600 UNIVERSITY ST STE 3100 SEATTLE, WA 98101 | LIFEWISE ASSURANCE COMPANY | $0 | $36K | $36K | 3.12% |
| WILLIS TOWERS WATSON US LLC4 Filed as: TOWERS WATSON PENNSYLVANIA INC | 1191 SECOND AVE #1400 SEATTLE, WA 98101 | LIFEWISE ASSURANCE COMPANY | $0 | $6K | $6K | 0.51% |
| WILLIS TOWERS WATSON US LLC4 Filed as: TOWERS WATSON DELAWARE INC. | 600 UNIVERSITY ST SUITE 3100 SEATTLE, WA 98101 | GROUP HEALTH OPTIONS, INC. | $8K | — | $8K | 0.85% |
| M HOLDINGS SECURITIES INC.3 | 1125 NW COUCH STREET, STE 900 ATTN COMMISSIONS DEPT PORTLAND, OR 972094129 | METROPOLITAN LIFE INSURANCE COMPANY | $14K | $2K | $16K | 1.84% |
| RODNEY BENCH3 | 601 UNION STREET, SUITE 1000 SEATTLE, WA 981014064 | METROPOLITAN LIFE INSURANCE COMPANY | $7K | — | $7K | 0.75% |
| LPL FINANCIAL CORP3 | 9785 TOWNE CENTRE DRIVE ATTN COMMISSIONS/PLAZA 8 SAN DIEGO, CA 921211968 | METROPOLITAN LIFE INSURANCE COMPANY | $2K | $609 | $3K | 0.29% |
| WILLAM BEAR3 | 321 NORTH CLARK STREET, FLOOR 14 ABI ATTN GARY KARLOWICZ CHICAGO, IL 606547593 | METROPOLITAN LIFE INSURANCE COMPANY | $2K | — | $2K | 0.25% |
| USI INSURANCE SERVICES LLC3 Filed as: KIBBLE AND PRENTICE HOLDING CO | 601 UNION STREET SUITE 1000 SEATTLE, WA 98101 | TRANSAMERICA LIFE INSURANCE COMPANY | $31K | — | $31K | 8.98% |
| LIFESTYLE INSURANCE SVCS INC3 | 30448 RANCHO VIEJO RD SUITE 180 SAN JUAN CAPISTRANO, CA 92675 | TRANSAMERICA LIFE INSURANCE COMPANY | $3K | — | $3K | 0.97% |
| RA BENCH INC3 Filed as: RA BENCH | 601 UNION STREET, SUITE 1000 SEATTLE, WA 98101 | METROPOLITAN LIFE INSURANCE COMPANY | $29K | — | $29K | 8.41% |
| LIFESTYLE INSURANCE SVCS INC3 Filed as: LIFESTYLE INSURANCE SERVICES,(MGA) | 30448 RANCHO VIEJO ROAD, SUITE 180 SAN JUAN CAPISTRANO, CA 92675 | METROPOLITAN LIFE INSURANCE COMPANY | $7K | — | $7K | 1.98% |
| KAREN A DACEK3 | 13665 NE ELLINGSEN RD, NE BAINBRIDGE ISLAND, WA 98110 | METROPOLITAN LIFE INSURANCE COMPANY | $4K | — | $4K | 1.05% |
| USI INSURANCE SERVICES LLC3 Filed as: KIBBLE & PRENTICE HOLDING CO INC | 601 UNION ST STE 1000 SEATTLE, WA 98101 | METROPOLITAN LIFE INSURANCE COMPANY | $2K | — | $2K | 0.45% |
| WILLIS TOWERS WATSON US LLC4 Filed as: TOWERS WATSON DELAWARE, INC. | PO BOX 28852 NEW YORK, NE 100878852 | VISION SERVICE PLAN | $2K | $193 | $2K | 0.90% |
| WILLIS TOWERS WATSON US LLC4 Filed as: TOWERS WATSON PENNSYLVANIA, INC. | P.O. BOX 8500, STOP 9102 PHILADELPHIA, PA 191789102 | VISION SERVICE PLAN | $409 | — | $409 | 0.19% |
| WILLIS TOWERS WATSON US LLC3 Filed as: TOWERS WATSON DELAWARE INC. | 600 UNIVERSITY STREET SUITE 3100 SEATTLE, WA 98101 | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | $4K | — | $4K | 2.21% |
| ECA FINANCIAL SERVICES INC3 Filed as: ECA FINANCIAL SERVICES INC. | STE B110 7373 E DOUBLETREE RANCH RD SCOTTSDALE, AZ 85258 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $10K | — | $10K | 15.99% |
| USI INSURANCE SERVICES LLC3 Filed as: KIBBLE & PRENTICE HOLDING COMPANY | 601 UNION STREET, SUITE 1000 SEATTLE, WA 981014064 | PRINCIPAL LIFE INSURANCE COMPANY | $7K | — | $7K | 13.16% |
| USI INSURANCE SERVICES LLC3 Filed as: KIBBLE & PRENTICE HOLDING COMPANY | 601 UNION STREET, SUITE 1000 SEATTLE, WA 98101 | PRINCIPAL LIFE INSURANCE COMPANY | $2K | $726 | $2K | 4.41% |
| WILLIS TOWERS WATSON US LLC4 Filed as: TOWERS WATSON DELAWARE INC | LOCKBOX 9102 PO BOX 9102 PHILADELPHIA, PA 19178 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $3K | — | $3K | 10.00% |
| USI INSURANCE SERVICES LLC3 Filed as: KIBBLE AND PRENTICE | 601 UNION STREET, STE 1000 SEATTLE, WA 98101 | HARTFORD LIFE INSURANCE | $4K | — | $4K | 15.00% |
| USI INSURANCE SERVICES LLC3 Filed as: KIBBLE AND PRENTICE HOLDING COMPANY | 601 UNION STREET, STE 1000 SEATTLE, WA 98101 | NATIONAL UNION FIRE INSURANCE COMPANY OF PITTSBURGH, PA | $3K | — | $3K | 15.00% |
| RA BENCH INC3 | 1301 5TH AVE #3525 SEATTLE, WA 98101 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $197 | — | $197 | 5.40% |
| GARDNER, CAROL ANN3 | 601 UNION ST STE 1000 STE 250 SAN JUAN CAPISTRANO, CA 92675 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $44 | $44 | 1.21% |
| RA BENCH INC3 | KIBBLE AND PRENTICE HOLDING CO 601 UNION ST STE 1000 SEATTLE, WA 98101 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $259 | — | $259 | 14.17% |
| CAROL GARDNER3 Filed as: CAROL A GARDNER | 30448 RANCHO VIEGO RD STE 250 SAN JUAN CAPISTRANO, CA 92675 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | — | $58 | $58 | 3.17% |
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 | 2,155 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 27 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 2,182 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | GROUP HEALTH OPTIONS, INC. | 141 | $1.2M |
| Dental(2 contracts, 2 carriers) | DELTA DENTAL OF WASHINGTON | 3,798 | $2.2M |
| Vision | VISION SERVICE PLAN | 1,384 | $220K |
| Life insurance(2 contracts, 2 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 2,129 | $2.2M |
| Short-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 2,129 | $1.3M |
| Long-term disability(2 contracts, 2 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 2,129 | $1.3M |
| Prescription drug(2 contracts, 2 carriers) | GROUP HEALTH OPTIONS, INC. | 141 | $1.2M |
| Stop-loss / reinsurancereinsurance | LIFEWISE ASSURANCE COMPANY | 1,812 | $1.2M |
| Other(9 contracts, 8 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 2,228 | $2.1M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 3,798 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.