| 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 98108 | GROUP HEALTH OPTIONS, INC. | $23K | — | $23K | 1.91% |
| EMERALD PACIFIC INSURANCE AGENCY3 Filed as: EMERALD PACIFIC INSURANCE COMPANY | PO BOX 917 MAPLE VALLEY, WA 98038 | GROUP HEALTH OPTIONS, INC. | $13K | — | $13K | 1.08% |
| USI INSURANCE SERVICES LLC3 Filed as: KIBBLE AND PRENTICE HOLDING COMPANY | 601 UNION STREET, SUITE 1000 SEATTLE, WA 98101 | GROUP HEALTH COOPERATIVE | $6K | — | $6K | 2.15% |
| EMERALD PACIFIC INSURANCE AGENCY3 | PO BOX 917 MAPLE VALLEY, WA 98038 | GROUP HEALTH COOPERATIVE | $3K | — | $3K | 1.15% |
| DEALER INSURANCE PRODUCTS, INC.3 | 22505 241ST AVENUE SE MAPLE VALLEY, WA 98038 | METROPOLITAN LIFE INSURANCE COMPANY | $4K | — | $4K | 1.59% |
| USI INSURANCE SERVICES LLC3 Filed as: KIBBLE AND PRENTICE HOLDING COMPANY | 601 UNION STREET, SUITE 1000 SEATTLE, WA 98101 | METROPOLITAN LIFE INSURANCE COMPANY | $3K | — | $3K | 1.32% |
| EMERALD PACIFIC INSURANCE AGENCY3 | 22505 241ST AVENUE SE MAPLE VALLEY, WA 98038 | EYEMED VISION CARE | $435 | — | $435 | 6.29% |
| USI INSURANCE SERVICES LLC3 Filed as: KIBBLE AND PRENTICE HOLDING COMPANY | 601 UNION STREET, SUITE 1000 SEATTLE, WA 98101 | EYEMED VISION CARE | $231 | — | $231 | 3.34% |
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 | 194 | 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) | 194 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | GROUP HEALTH OPTIONS, INC. | 263 | $1.5M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 473 | $232K |
| Vision | EYEMED VISION CARE | 150 | $7K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 473 | $232K |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 473 | $232K |
| Prescription drug(2 contracts, 2 carriers) | GROUP HEALTH OPTIONS, INC. | 263 | $1.5M |
| Other | METROPOLITAN LIFE INSURANCE COMPANY | 473 | $232K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 473 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.