| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: KIBBLE AND PRENTICE HOLDING COMPANY | 601 UNION STREET, SUITE 1000 SEATTLE, WA 98101 | GROUP HEALTH OPTIONS INC. | $94K | $0 | $94K | 11.60% |
| USI INSURANCE SERVICES LLC3 Filed as: KIBBLE AND PRENTICE HOLDING COMPANY | 601 UNION STREET, SUITE 1000 SEATTLE, WA 98101 | METROPOLITAN LIFE INSURANCE COMPANY | $49K | $0 | $49K | 10.85% |
| USI INSURANCE SERVICES LLC3 Filed as: KIBBLE AND PRENTICE HOLDING COMPANY | 601 UNION STREET, SUITE 1000 SEATTLE, WA 98101 | HARTFORD LIFE AND ACCIDENT | $46K | $0 | $46K | 15.00% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 470 PARK AVENUE SOUTH, 6TH FLOOR NEW YORK, NY 10016 | HARTFORD LIFE AND ACCIDENT | $0 | $6K | $6K | 2.09% |
| BARBARA M DICKSON3 Filed as: BARBARA DICKSON | 8040 161ST AVENUE NE, SUITE 411 REDMOND, WA 98052 | AFLAC | $23K | $1K | $25K | 16.64% |
| SANDI LOHNES3 | PO BOX 678 EASTON, WA 98925 | AFLAC | $2K | $129 | $2K | 1.62% |
| DAVID J MCCLELLAN3 Filed as: DAVID JOHN HANNANT | 14830 NE 167TH STREET WOODINVILLE, WA 98072 | AFLAC | $2K | $273 | $2K | 1.52% |
| MJ INSURANCE3 Filed as: SCOTT STOBAUGH AND VARIOUS AGENTS | 704 228TH AVENUE NE, SUITE 774 SAMMAISH, WA 98074 | AFLAC | $2K | $0 | $2K | 1.27% |
| DEBORAH R. WALLACE3 | 8040 161ST AVENUE NE, SUITE 349 REDMOND, WA 98052 | AFLAC | $697 | $144 | $841 | 0.56% |
| JACOB J MCINTOSH3 Filed as: JACOB J. MCINTOSH | 7180 SW FIR LOOP, SUITE 250 TIGARD, OR 97223 | AFLAC | $506 | $273 | $779 | 0.52% |
| BRAD FISHER3 | 915 2ND AVENUE, M/S W214 SEATTLE, WA 98174 | AFLAC | $680 | $0 | $680 | 0.46% |
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 | 634 | 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) | 634 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | GROUP HEALTH OPTIONS INC. | 682 | $810K |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 1,052 | $455K |
| Vision | GROUP HEALTH OPTIONS INC. | 682 | $810K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 1,878 | $309K |
| Short-term disability(2 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 1,878 | $458K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 1,878 | $309K |
| Prescription drug | GROUP HEALTH OPTIONS INC. | 682 | $810K |
| Other | HARTFORD LIFE AND ACCIDENT | 1,878 | $309K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,878 | — |
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 compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.