| 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 | $55K | $1K | $56K | 4.24% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62949 VIRGINIA BEACH, VA 23466 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $5K | $0 | $5K | 5.55% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62889 VIRGINIA BEACH, VA 23466 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $0 | $3K | $3K | 2.83% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62949 VIRGINIA BEACH, VA 23466 | VISION SERVICE PLAN | $1K | $0 | $1K | 5.49% |
| DONALD J. CLAY3 | 12405 NE 6TH COURT VANCOUVER, WA 98685 | AFLAC | $849 | $62 | $911 | 8.02% |
| SHANE SCALF3 Filed as: SHANE SCALF AND OTHER AGENTS | 809 NE 10TH STREET BATTLE GROUND, WA 98604 | AFLAC | $392 | $0 | $392 | 3.45% |
| RYAN DONALD AUGHENBAUGH3 Filed as: RYAN DONALD AUGHENBOUGH | 16543 SOUTH WINDY CITY ROAD MULINO, OR 97042 | AFLAC | $210 | $14 | $224 | 1.97% |
| JAMES S SARANTIS3 Filed as: JAMES S. SARANTIS | 14132 SE FIRCREST COURT PORTLAND, OR 97236 | AFLAC | $131 | $14 | $145 | 1.28% |
| JEAN ANN SCHINDELHEIM3 | 554 DEW POINT AVENUE CARLSBAD, CA 92011 | AFLAC | $112 | $0 | $112 | 0.99% |
| VERENA NORTH3 | 17299 SOUTH NORTH END ROAD OREGON CITY, OR 97045 | AFLAC | $95 | $0 | $95 | 0.84% |
| STEPHANIE L SANDERS3 Filed as: STEPHANIE L. SANDERS | 27305 LIVE OAK ROAD, SUITE A437 SANTA CLARITA, CA 91384 | AFLAC | $69 | $0 | $69 | 0.61% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 4622 PENNSYLVANIA AVENUE, SUITE 900 KANSAS CITY, MO 64112 | UNITEDHEALTHCARE INSURANCE COMPANY | $591 | $0 | $591 | 9.22% |
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 | 94 | 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) | 94 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | REGENCE BLUECROSS BLUESHIELD OF OREGON | 136 | $2.0M |
| Dental | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 124 | $98K |
| Vision | VISION SERVICE PLAN | 126 | $19K |
| Life insurance(2 contracts, 2 carriers) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 124 | $105K |
| Short-term disability | AFLAC | 13 | $11K |
| Prescription drug(2 contracts, 2 carriers) | REGENCE BLUECROSS BLUESHIELD OF OREGON | 136 | $2.0M |
| Other(2 contracts, 2 carriers) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 124 | $110K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 136 | — |
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.