| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NORTHWEST | 825 NE MULTNOMAH STREET, SUITE 1500 PORTLAND, OR 97232 | PROVIDENCE HEALTH PLAN | $31K | $0 | $31K | 3.00% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NORTHWEST | 825 NE MULTNOMAH STREET, SUITE 1500 PORTLAND, OR 97232 | WILLAMETTE DENTAL INSURANCE, INC. | $6K | $0 | $6K | 5.00% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62949 VIRGINIA BEACH, VA 23466 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $4K | $0 | $4K | 15.00% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62889 VIRGINIA BEACH, VA 23466 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $0 | $818 | $818 | 3.16% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62949 VIRGINIA BEACH, VA 23466 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $2K | $266 | $2K | 11.41% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62949 VIRGINIA BEACH, VA 23466 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $1K | $0 | $1K | 11.94% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62889 VIRGINIA BEACH, VA 23466 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $0 | $376 | $376 | 3.64% |
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 | 347 | 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) | 347 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | PROVIDENCE HEALTH PLAN | 233 | $1.0M |
| Dental(2 contracts, 2 carriers) | WILLAMETTE DENTAL INSURANCE, INC. | 208 | $127K |
| Vision | PROVIDENCE HEALTH PLAN | 233 | $1.0M |
| Life insurance(2 contracts) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 347 | $36K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 38 | $26K |
| Prescription drug | PROVIDENCE HEALTH PLAN | 233 | $1.0M |
| Other(2 contracts) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 347 | $36K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 347 | — |
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.