| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI NORTHWEST | 700 NE MULTNOMAH, SUITE 1300 PORTLAND, OR 97232 | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | $43K | — | $43K | 2.13% |
| USI INSURANCE SERVICES LLC3 Filed as: USI NORTHWEST | 700 NE MULTNOMAH, SUITE 1300 PORTLAND, OR 97232 | PROVIDENCE HEALTH PLAN | $22K | — | $22K | 1.78% |
| USI INSURANCE SERVICES LLC3 Filed as: USI NORTHWEST | 700 NE MULTNOMAH, SUITE 1300 PORTLAND, OR 97232 | STANDARD INSURANCE COMPANY | $3K | — | $3K | 2.07% |
| M FINANCIAL HOLDING INC3 Filed as: M FINANCIAL HOLDING, INC. | 1125 NW COUCH STREET, SUITE 900 PORTLAND, OR 97290 | SUN LIFE ASSURANCE COMPANY OF CANADA | — | $1K | $1K | 14.39% |
| USI INSURANCE SERVICES LLC3 Filed as: USI NORTHWEST | 700 NE MULNOMAH, SUITE 1300 PORTLAND, OR 97232 | SUN LIFE ASSURANCE COMPANY OF CANADA | $1K | — | $1K | 14.18% |
| USI INSURANCE SERVICES LLC3 Filed as: USI NORTHWEST | 700 NE MULTNOMAH, SUITE 1300 PORTLAND, OR 97232 | QBE INSURANCE CORPORATION | $120 | — | $120 | 15.00% |
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 | 540 | 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) | 540 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | 268 | $3.3M |
| Dental(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | 268 | $2.2M |
| Vision | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | 268 | $2.0M |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 540 | $9K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 540 | $9K |
| Prescription drug(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | 268 | $3.3M |
| Other(3 contracts, 3 carriers) | RELIANT BEHAVIORAL HEALTH, LLC | 540 | $29K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 540 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.