| 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 | REGENCE BLUECROSS BLUESHIELD OF OREGON | $66K | $0 | $66K | 4.56% |
| RICHIED AND ASSOCIATES, INC.3 Filed as: RICHIED AND ASSOCIATES | 10425 DOUBLE R BOULEVARD RENO, NV 89521 | HOMETOWN HEALTH | $27K | $0 | $27K | 3.78% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62949 VIRGINIA BEACH, VA 23466 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $6K | $0 | $6K | 5.22% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62889 VIRGINIA BEACH, VA 23466 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $0 | $4K | $4K | 3.59% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62949 VIRGINIA BEACH, VA 23466 | VISION SERVICE PLAN | $1K | $0 | $1K | 5.29% |
| STEPHANIE L SANDERS3 Filed as: STEPHANIE SANDERS AND OTHER AGENTS | 27305 LIVE OAK ROAD, SUITE A437 SANTA CLARITA, CA 91384 | AFLAC | $446 | $12 | $458 | 4.01% |
| MARIE HELENA EVANS3 | 13004 NW MARINA WAY PORTLAND, OR 97231 | AFLAC | $194 | $0 | $194 | 1.70% |
| VERENA NORTH3 | 17299 SOUTH NORTH END ROAD OREGON CITY, OR 97045 | AFLAC | $191 | $0 | $191 | 1.67% |
| DONALD J. CLAY3 | 12405 NE 6TH COURT VANCOUVER, WA 98685 | AFLAC | $128 | $61 | $189 | 1.65% |
| SHANE SCALF3 | 809 NE 10TH STREET BATTLE GROUND, WA 98604 | AFLAC | $106 | $12 | $118 | 1.03% |
| JEAN ANN SCHINDELHEIM3 | 554 DEW POINT AVENUE CARLSBAD, CA 92011 | AFLAC | $95 | $0 | $95 | 0.83% |
| PAUL LANGAS3 Filed as: PAUL JON LANGAS | 4025 NW 77TH AVENUE CAMAS, WA 98607 | AFLAC | $81 | $0 | $81 | 0.71% |
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 | 122 | 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) | 122 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | REGENCE BLUECROSS BLUESHIELD OF OREGON | 170 | $2.2M |
| Dental | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 165 | $107K |
| Vision | VISION SERVICE PLAN | 165 | $23K |
| Life insurance(2 contracts, 2 carriers) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 165 | $115K |
| Short-term disability | AFLAC | 15 | $11K |
| Prescription drug(2 contracts, 2 carriers) | REGENCE BLUECROSS BLUESHIELD OF OREGON | 170 | $2.2M |
| Other(2 contracts, 2 carriers) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 165 | $119K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 170 | — |
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.