| 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 | $67K | $53 | $67K | 5.26% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: ARUTHUR J GALLAGHER RISK MANAGEMENT | 10425 DOUBLE R BOULEVARD RENO, NV 89521 | HOMETOWN HEALTH | $22K | $0 | $22K | 3.79% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62949 VIRGINIA BEACH, VA 23466 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $5K | $0 | $5K | 5.08% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62889 VIRGINIA BEACH, VA 23466 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $0 | $3K | $3K | 2.99% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62949 VIRGINIA BEACH, VA 23466 | VISION SERVICE PLAN | $1K | $0 | $1K | 5.71% |
| PAUL LANGAS3 Filed as: PAUL JON LANGAS AND OTHER AGENTS | 8910 NORTH JUNIPER STREET CAMAS, WA 98607 | AFLAC | $248 | $0 | $248 | 3.93% |
| DONALD J. CLAY3 | 12405 NE 6TH COURT VANCOUVER, WA 98685 | AFLAC | $188 | $0 | $188 | 2.98% |
| JEAN ANN SCHINDELHEIM3 | 554 DEW POINT AVENUE CARLSBAD, CA 92011 | AFLAC | $104 | $0 | $104 | 1.65% |
| STEPHANIE L SANDERS3 Filed as: STEPHANIE L. SANDERS | PO BOX 800186 SANTA CLARITA, CA 91380 | AFLAC | $64 | $0 | $64 | 1.01% |
| VERENA NORTH3 | 17299 SOUTH NORTH END ROAD OREGON CITY, OR 97045 | AFLAC | $58 | $0 | $58 | 0.92% |
| SHANE SCALF3 | 809 NE 10TH STREET BATTLE GROUND, WA 98604 | AFLAC | $32 | $0 | $32 | 0.51% |
| GEOFFREY MALAIS3 | PO BOX 280717 NORTHRIDGE, CA 91328 | AFLAC | $30 | $0 | $30 | 0.48% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 4622 PENNSYLVANIA AVENUE, SUITE 900 KANSAS CITY, MO 64112 | UNITEDHEALTHCARE INSURANCE COMPANY | $611 | $0 | $611 | 10.91% |
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 | 130 | 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) | 130 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | REGENCE BLUECROSS BLUESHIELD OF OREGON | 133 | $1.8M |
| Dental | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 124 | $91K |
| Vision | VISION SERVICE PLAN | 130 | $18K |
| Life insurance(2 contracts, 2 carriers) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 124 | $96K |
| Short-term disability | AFLAC | 11 | $6K |
| Prescription drug(2 contracts, 2 carriers) | REGENCE BLUECROSS BLUESHIELD OF OREGON | 133 | $1.8M |
| Other(2 contracts, 2 carriers) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 124 | $97K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 133 | — |
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.