| 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 | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | $0 | $1K | $1K | 0.02% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NORTHWEST | 601 UNION STREET, SUITE 1000 SEATTLE, WA 98101 | AETNA LIFE INSURANCE COMPANY | $0 | $2K | $2K | 0.50% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62949 VIRGINIA BEACH, VA 23466 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $12K | $5K | $17K | 7.77% |
| HEARTSEASE LLC3 Filed as: HEARTSEASE, LLC | 1521 NE 63RD AVENUE HILLSBORO, OR 97124 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $4K | $595 | $5K | 4.25% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NORTHWEST | 601 UNION STREET, SUITE 1000 SEATTLE, WA 98101 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $27 | $2K | 2.17% |
| KAREN CLAY KUNKLER3 | 1709 NW 45TH AVENUE CAMAS, WA 98607 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $304 | $2K | 2.03% |
| BENEFITS BY DESIGN INC3 Filed as: BENEFITS BY DESIGN INC. | 2101 NE 279TH STREET RIDGEFIELD, WA 98642 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $168 | $2K | 1.40% |
| PREMIER WORKSITE SOLUTIONS INC3 Filed as: PREMIER WORKSITE SOLUTIONS INC. | 112 NW 114TH STREET VANCOUVER, WA 98685 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $345 | $2K | 1.40% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NORTHWEST | 825 NE MULTNOMAH STREET, SUITE 1500 PORTLAND, OR 97232 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $0 | $1K | 0.93% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS AND AGENTS | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $975 | $26 | $1K | 0.92% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NORTHWEST | 825 NE MULTNOMAH STREET, SUITE 1500 PORTLAND, OR 97232 | ZURICH AMERICAN INSURANCE COMPANY | $437 | $0 | $437 | 14.99% |
| USI INSURANCE SERVICES LLC3 | 825 NE MULTNOMAH STREET, SUITE 1500 PORTLAND, OR 97232 | THE PAUL REVERE LIFE INSURANCE COMPANY | $2 | $0 | $2 | 4.88% |
| PREMIER WORKSITE SOLUTIONS INC3 Filed as: PREMIER WORKSITE SOLUTIONS INC. | 112 NW 114TH STREET VANCOUVER, WA 98685 | THE PAUL REVERE LIFE INSURANCE COMPANY | $1 | $0 | $1 | 2.44% |
| BENEFITS BY DESIGN INC3 Filed as: BENEFITS BY DESIGN INC. | 2101 NE 279TH STREET RIDGEFIELD, WA 98642 | THE PAUL REVERE LIFE INSURANCE COMPANY | $1 | $0 | $1 | 2.44% |
| MARK J ROBISON3 Filed as: MARK J. ROBISON | 1255 KIENAS ROAD KALISPELL, MT 59901 | THE PAUL REVERE LIFE INSURANCE COMPANY | $1 | $0 | $1 | 2.44% |
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 | 324 | 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) | 324 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | 761 | $4.7M |
| Vision(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | 761 | $4.3M |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 324 | $214K |
| Short-term disability(3 contracts, 3 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 324 | $323K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 324 | $214K |
| Prescription drug(3 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | 761 | $4.7M |
| Other(5 contracts, 5 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 324 | $326K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 761 | — |
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 comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.
Multiple-employer welfare arrangement. Specific regulatory and compliance context; specific consultant niche.