| 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 | UNITEDHEALTHCARE INSURANCE COMPANY | $75K | $15K | $90K | 3.93% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62949 VIRGINIA BEACH, VA 23466 | DELTA DENTAL OF WASHINGTON | $7K | $0 | $7K | 5.00% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62949 VIRGINIA BEACH, VA 23466 | METROPOLITAN LIFE INSURANCE COMPANY | $10K | $2K | $12K | 11.39% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62949 VIRGINIA BEACH, VA 23466 | VISION SERVICE PLAN | $925 | $0 | $925 | 6.21% |
| DVG INSURANCE, INC.3 | 6512 18TH AVENUE NW SEATTLE, WA 98117 | AFLAC | $4K | $0 | $4K | 30.63% |
| BRUNN & COMPANY INC.3 Filed as: BRUNN AND COMPANY, INC. | 19225 NE 202ND STREET WOODINVILLE, WA 98077 | AFLAC | $1K | $0 | $1K | 7.38% |
| JAMEY MILLER INC3 Filed as: JAMEY MILLER, INC. | 12942 193RD AVENUE EAST BONNEY LAKE, WA 98391 | AFLAC | $697 | $0 | $697 | 4.79% |
| DAVID GEHR3 Filed as: DAVID VON GEHR | 6512 18TH AVENUE NW SEATTLE, WA 98117 | AFLAC | $130 | $0 | $130 | 0.89% |
| MJ INSURANCE3 Filed as: MICHAEL E. BRUNN AND VARIOUS AGENTS | 19225 NE 202ND STREET WOODINVILLE, WA 98077 | AFLAC | $83 | $0 | $83 | 0.57% |
| DEBORAH R. WALLACE3 | PO BOX 2103 ALLYN, WA 98524 | AFLAC | $46 | $0 | $46 | 0.32% |
| NORTHWEST BENEFIT ADVISORS, INC.3 | 11811 NE 1ST STREET SUITE 302 BELLEVUE, WA 98005 | AFLAC | $34 | $0 | $34 | 0.23% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NORTHWEST | 601 UNION STREET, SUITE 1000 SEATTLE, WA 98101 | WILLAMETTE DENTAL GROUP | $227 | $0 | $227 | 4.99% |
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 | 164 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 167 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITEDHEALTHCARE INSURANCE COMPANY | 287 | $2.3M |
| Dental(3 contracts, 3 carriers) | DELTA DENTAL OF WASHINGTON | 251 | $165K |
| Vision | VISION SERVICE PLAN | 135 | $15K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 164 | $104K |
| Short-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 164 | $104K |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 164 | $104K |
| Prescription drug | UNITEDHEALTHCARE INSURANCE COMPANY | 287 | $2.3M |
| Other(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 164 | $119K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 287 | — |
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.