| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: KIBBLE & PRENTICE HOLDING COMPANY | 601 UNION STREET SUITE 1000 SEATTLE, WA 98101 | REGENCE BLUESHIELD | $50K | $103 | $50K | 1.64% |
| MERCER HEALTH AND BENEFITS, LLC3 | 1301 5TH AVE SUITE 1900 SEATTLE, WA 98101 | REGENCE BLUESHIELD | $20K | $1K | $21K | 0.68% |
| USI INSURANCE SERVICES LLC3 Filed as: KIBBLE & PRENTICE HOLDING COMPANY | 601 UNION STREET, SUITE 1000 SEATTLE, WA 98101 | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON | $31K | — | $31K | 3.04% |
| MERCER HEALTH AND BENEFITS, LLC3 | 1301 FIFTH AVENUE SUITE 1900 SEATTLE, WA 98101 | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON | $10K | — | $10K | 0.96% |
| USI INSURANCE SERVICES LLC3 Filed as: KIBBLE & PRENTICE HOLDING COMPANY | DBA USI NORTHWEST 601 UNION STREET, SUITE 1000 SEATTLE, WA 98101 | DELTA DENTAL OF WASHINGTON | $4K | — | $4K | 0.79% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | DELTA DENTAL OF WASHINGTON | $2K | — | $2K | 0.41% |
| USI INSURANCE SERVICES LLC3 Filed as: KIBBLE & PRENTICE HOLDING COMPANY | DBA USI NORTHWEST P.O. BOX 62949 VIRGINIA BEACH, VA 23466 | SUN LIFE ASSURANCE COMPANY OF CANADA | $22K | — | $22K | 7.26% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | SUN LIFE ASSURANCE COMPANY OF CANADA | $7K | — | $7K | 2.19% |
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 | 476 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 6 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 482 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | REGENCE BLUESHIELD | 636 | $4.1M |
| Dental | DELTA DENTAL OF WASHINGTON | 874 | $444K |
| Vision(2 contracts, 2 carriers) | REGENCE BLUESHIELD | 636 | $4.1M |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 478 | $302K |
| Short-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 478 | $302K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 478 | $302K |
| Prescription drug(2 contracts, 2 carriers) | REGENCE BLUESHIELD | 636 | $4.1M |
| Other(2 contracts, 2 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 478 | $309K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 874 | — |
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."
No prospect flags tripped on this filing.