| 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 | $34K | — | $34K | 1.56% |
| USI INSURANCE SERVICES LLC3 Filed as: KIBBLE & PRENTICE HOLDING COMPANY | SUITE 100 601 UNION STREET SEATTLE, WA 981014064 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $89K | — | $89K | 6.74% |
| USI INSURANCE SERVICES LLC3 | PO BOX 3716 ATTN ACCOUNTING CENTER NORFOLK, VI 235143716 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $13K | — | $13K | 1.00% |
| PILLAR INTERNATIONAL INS ADVISORS3 Filed as: PILLAR INTERNATIONAL INS | 601 UNION ST SEATTLE, WA 98101 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $8K | — | $8K | 0.64% |
| AXA ASSISTANCE, USA5 | 122 SOUTH MICHIGAN AVENUE, STE 1100 CHICAGO, IL 606036115 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $532 | $532 | 0.04% |
| WILLIS TOWERS WATSON US LLC4 Filed as: TOWERS WATSON DELAWARE INC. | LOCK BOX 28852 PO BOX 28852 NEW YORK, NY 10087 | GROUP HEALTH OPTIONS, INC. | $7K | — | $7K | 0.79% |
| M HOLDINGS SECURITIES INC.3 | 1125 NW COUCH STREET, STE 900 ATTN COMMISSIONS DEPT PORTLAND, OR 972094129 | METROPOLITAN LIFE INSURANCE COMPANY | $14K | — | $14K | 1.67% |
| RODNEY BENCH3 | 601 UNION STREET, SUITE 1000 SEATTLE, WA 981014064 | METROPOLITAN LIFE INSURANCE COMPANY | $6K | — | $6K | 0.74% |
| LPL FINANCIAL CORP3 | 4707 EXECUTIVE DR ATTN CLIENT COMPENSATION DEPARTMENT SAN DIEGO, CA 921213091 | METROPOLITAN LIFE INSURANCE COMPANY | $5K | $729 | $5K | 0.64% |
| WILLAM BEAR3 | 321 NORTH CLARK STREET, FLOOR 14 ABI ATTN GARY KARLOWICZ CHICAGO, IL 606547593 | METROPOLITAN LIFE INSURANCE COMPANY | $2K | — | $2K | 0.25% |
| WILLIS TOWERS WATSON US LLC3 Filed as: TOWERS WATSON DELAWARE INC. | PO BOX 28852 NEW YORK, NY 100878852 | KAISER FOUNDATION HEALTH PLAN INC. | $12K | — | $12K | 2.92% |
| RA BENCH INC3 Filed as: RA BENCH | 601 UNION STREET, SUITE 1000 SEATTLE, WA 98101 | METROPOLITAN LIFE INSURANCE COMPANY | $30K | — | $30K | 8.53% |
| LIFESTYLE INSURANCE SVCS INC3 Filed as: LIFESTYLE INSURANCE SERVICES,(MGA) | 30270 RANCHO VIEJO ROAD, SUITE B SAN JUAN CAPISTRANO, CA 92675 | METROPOLITAN LIFE INSURANCE COMPANY | $7K | — | $7K | 2.00% |
| KAREN A DACEK3 | 7784 HANSEN RD NE BAINBRIDGE ISLAND, WA 98110 | METROPOLITAN LIFE INSURANCE COMPANY | $4K | — | $4K | 1.01% |
| USI INSURANCE SERVICES LLC3 Filed as: KIBBLE & PRENTICE HOLDING CO INC | PO BOX 62949 VIRGINIA BEACH, VA 23466 | METROPOLITAN LIFE INSURANCE COMPANY | $1K | — | $1K | 0.43% |
| WILLIS TOWERS WATSON US LLC4 Filed as: TOWERS WATSON DELAWARE, INC. | PO BOX 28852 NEW YORK, NE 100878852 | VISION SERVICE PLAN | $2K | — | $2K | 1.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: TOWERS WATSON DELAWARE INC. | LOCK BOX 28852 PO BOX 28852 NEW YORK, NY 10087 | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | $5K | $127 | $5K | 2.06% |
| USI INSURANCE SERVICES LLC3 Filed as: KIBBLE AND PRENTICE HOLDING CO | 601 UNION STREET SUITE 1000 SEATTLE, WA 98101 | TRANSAMERICA LIFE INSURANCE COMPANY | $28K | — | $28K | 16.14% |
| LIFESTYLE INSURANCE SVCS INC3 | 30270 RANCHO VIEJO RD SUITE B SAN JUAN CAPISTRANO, CA 92675 | TRANSAMERICA LIFE INSURANCE COMPANY | $3K | — | $3K | 1.84% |
| 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 | 13.85% |
| USI INSURANCE SERVICES LLC3 Filed as: KIBBLE & PRENTICE HOLDING COMPANY | PO BOX 62949 VIRGINIA BCH, VA 234662949 | PRINCIPAL LIFE INSURANCE COMPANY | $6K | $968 | $7K | 15.26% |
| USI INSURANCE SERVICES LLC3 Filed as: KIBBLE AND PRENTICE | 601 UNION STREET, STE 1000 SEATTLE, WA 98101 | HARTFORD LIFE INSURANCE | $4K | $656 | $4K | 17.62% |
| RA BENCH INC3 | KIBBLE AND PRENTICE HOLDING CO 601 UNION ST STE 1000 SEATTLE, WA 98101 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $360 | — | $360 | 5.40% |
| CAROL GARDNER3 Filed as: CAROL A GARDNER | 30448 RANCHO VIEGO RD STE 250 SAN JUAN CAPISTRANO, CA 92675 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | — | $80 | $80 | 1.20% |
| USI INSURANCE SERVICES LLC3 Filed as: KIBBLE & PRENTICE HOLDING CO | 601 UNION ST SUITE 1000 SEATTLE, WA 98101 | TRANSAMERICA FINANCIAL LIFE INSURANCE COMPANY | $2K | — | $2K | 40.92% |
| LIFESTYLE INSURANCE SVCS INC3 | 30270 RANCHO VIEJO RD SUITE B SAN JUAN CAPISTRANO, CA 92675 | TRANSAMERICA FINANCIAL LIFE INSURANCE COMPANY | $185 | — | $185 | 3.25% |
| RA BENCH INC3 | 601 UNION ST STE 1000 SEATTLE, WA 98101 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $197 | — | $197 | 5.40% |
| GARDNER, CAROL ANN3 | 30448 RANCHO VIEGO RD STE 250 SAN JUAN CAPISTRANO, CA 92675 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $44 | $44 | 1.21% |
| WILLIS TOWERS WATSON US LLC4 Filed as: TOWERS WATSON DELAWARE INC | LOCK BOX 28852 PO BOX 28852 NEW YORK, NY 10087 | LIFEWISE ASSURANCE COMPANY | — | $18K | $18K | — |
| WILLIS TOWERS WATSON US LLC4 Filed as: TOWERS WATSON DELAWARE INC | LOCK BOX 28852 NEW YORK, NY 10087 | PREMERA BLUE CROSS | $31K | — | $31K | — |
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 | 2,213 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 54 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 2,267 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 4 carriers) | GROUP HEALTH OPTIONS, INC. | 120 | $1.5M |
| Dental(2 contracts, 2 carriers) | DELTA DENTAL OF WASHINGTON | 3,801 | $2.2M |
| Vision | VISION SERVICE PLAN | 1,385 | $244K |
| Life insurance(2 contracts, 2 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 2,189 | $2.1M |
| Short-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 2,189 | $1.3M |
| Long-term disability(2 contracts, 2 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 2,189 | $1.4M |
| Prescription drug(3 contracts, 3 carriers) | GROUP HEALTH OPTIONS, INC. | 120 | $1.5M |
| Stop-loss / reinsurancereinsurance(3 contracts, 3 carriers) | NATIONAL UNION FIRE INSURANCE COMPANY OF PITTSBURGH, PA | 1,845 | $1.1M |
| Other(10 contracts, 9 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 2,276 | $2.0M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 3,801 | — |
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."
No prospect flags tripped on this filing.