| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: KIBBLE AND PRENTICE HOLDING COMPANY | 601 UNION STREET, SUITE 1000 SEATTLE, WA 98101 | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | $88K | $0 | $88K | 1.23% |
| UNKNOWN3 | UNKNOWN PORTLAND, OR 97203 | OREGON DENTAL SERVICE DBA DELTA DENTAL PLAN OF OREGON | $5K | $0 | $5K | 1.22% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62949 VIRGINIA BEACH, VA 23456 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $37K | $0 | $37K | 13.52% |
| USI INSURANCE SERVICES LLC3 | PO BOX 3716 NORFOLK, VA 23414 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $0 | $4K | $4K | 1.49% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62949 VIRGINIA BEACH, VA 23466 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $840 | $0 | $840 | 3.65% |
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 | 749 | 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) | 749 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | 1,297 | $7.2M |
| Dental(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | 1,297 | $7.6M |
| Vision | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | 1,297 | $7.2M |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 749 | $270K |
| Long-term disability(2 contracts, 2 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 749 | $293K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | 1,297 | $7.2M |
| Other(2 contracts, 2 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 749 | $286K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,297 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.