| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: KIBBLE & PRENTICE HOLDING COMPANY | 601 UNION STREET, STE 1000 SEATTLE, WA 98101 | KAISER PERMANENTE | $72K | — | $72K | 0.20% |
| USI INSURANCE SERVICES LLC3 Filed as: KIBBLE & PRENTICE HOLDING COMPANY | 601 UNION STREET, STE 1000 SEATTLE, WA 98101 | KAISER PERMANENTE | $65K | — | $65K | 0.20% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NA | PO BOX 62949 VIRGINIA BEACH, VA 23466 | NEW YORK LIFE INSURANCE COMPANY | $59K | — | $59K | 2.00% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NA | PO BOX 62949 VIRGINIA BEACH, VA 23466 | NEW YORK LIFE INSURANCE COMPANY | $53K | — | $53K | 2.50% |
| USI INSURANCE SERVICES LLC3 Filed as: KIBBLE & PRENTICE HOLDING COMPANY | 601 UNION STREET, STE 1000 SEATTLE, WA 98101 | WILLAMETTE DENTAL, INC. | — | $107K | $107K | 6.00% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NA | PO BOX 62949 VIRGINIA BEACH, VA 23466 | NEW YORK LIFE GROUP BENEFIT SOLUTIONS | $32K | — | $32K | 10.00% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NA | PO BOX 62949 VIRGINIA BEACH, VA 23466 | NEW YORK LIFE GROUP BENEFIT SOLUTIONS | $0 | — | $0 | 0.00% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NA | PO BOX 62949 VIRGINIA BEACH, VA 23466 | NEW YORK LIFE GROUP BENEFIT SOLUTIONS | $10K | — | $10K | 10.00% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NA | PO BOX 62949 VIRGINIA BEACH, VA 23466 | NEW YORK LIFE GROUP BENEFIT SOLUTIONS | $0 | — | $0 | 0.00% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NA | PO BOX 62949 VIRGINIA BEACH, VA 23466 | CIGNA GROUP INSURANCE | $72 | $36 | $108 | 15.08% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NA | PO BOX 62949 VIRGINIA BEACH, VA 23466 | NEW YORK LIFE INSURANCE COMPANY | $0 | — | $0 | 0.00% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NA | PO BOX 62949 VIRGINIA BEACH, VA 23466 | CIGNA GROUP INSURANCE | $0 | $9K | $9K | — |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NA | PO BOX 62949 VIRGINIA BEACH, VA 23466 | CIGNA GROUP INSURANCE | $0 | $2K | $2K | — |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NA | PO BOX 62949 VIRGINIA BEACH, VA 23466 | CIGNA GROUP INSURANCE | $0 | $8K | $8K | — |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NA | PO BOX 62949 VIRGINIA BEACH, VA 23466 | CIGNA GROUP INSURANCE | $0 | $20K | $20K | — |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UNITED HEALTH CARE INSURANCE CO EIN 36-2739571 NONE | Other services; Claims processing Service code 12 | — | $643K |
| NEW YORK LIFE INSURANCE CO EIN 06-0303370 NONE | Claims processing Service code 12 | — | $296K |
| DAVIS WRIGHT TREMAINE EIN 91-0839480 NONE | Legal Service code 29 | — | $178K |
| WILLAMETTE DENTAL EIN 91-0621480 NONE | Claims processing Service code 12 | — | $176K |
| MERCER EIN 13-2834414 NONE | Actuarial Service code 11 | — | $68K |
| WAGEWORKS, INC EIN 94-3351864 NONE | Claims processing Service code 12 | — | $55K |
| MOSS ADAMS LLP EIN 91-0189318 NONE | Accounting (including auditing) Service code 10 | — | $44K |
| EXPRESS SCRIPTS EIN 41-1627938 NONE | Claims processing Service code 12 | — | $22K |
| AON EIN 22-2232264 NONE | Consulting (general) Service code 16 | — | $21K |
| SPECTERA EIN 36-2739571 NONE | Claims processing Service code 12 | — | $4K |
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 | 5,176 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 287 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 5,463 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts) | KAISER PERMANENTE | 5,306 | $68.8M |
| Dental | WILLAMETTE DENTAL, INC. | 3,157 | $1.8M |
| Vision(2 contracts) | KAISER PERMANENTE | 5,306 | $68.8M |
| Life insurance(8 contracts, 3 carriers) | NEW YORK LIFE INSURANCE COMPANY | 7,169 | $2.5M |
| Short-term disability(3 contracts, 3 carriers) | NEW YORK LIFE INSURANCE COMPANY | 4,778 | $3.0M |
| Long-term disability | NEW YORK LIFE GROUP BENEFIT SOLUTIONS | 5,099 | $158K |
| Prescription drug(2 contracts) | KAISER PERMANENTE | 5,306 | $68.8M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 7,169 | — |
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 comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.