| 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 | HEALTH NET | $11K | — | $11K | 2.50% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 975 OAK STREET, SUITE 900 EUGENE, OR 97401 | WILLAMETTE DENTAL INSURANCE, INC. | $972 | — | $972 | 2.50% |
| MARY ESTHER TAYLOR3 | 1126 GATEWAY LOOP SPRINGFIELD, OR 97477 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $15 | $2K | 6.67% |
| USI INSURANCE SERVICES LLC3 Filed as: KIBBLE AND PRENTICE HOLDING COMPANY | 601 UNION STREET, SUITE 1000 SEATTLE, WA 98101 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $502 | $60 | $562 | 1.97% |
| PACIFIC BENEFIT CONSULTANTS3 Filed as: PACIFIC BENEFIT CONSULTANTS, INC. | 450 COUNTRY CLUB ROAD, SUITE 330 EUGENE, OR 97401 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $484 | — | $484 | 1.70% |
| RITA J ROBINSON3 Filed as: RITA J. ROBINSON AND OTHER AGENTS | PO BOX 34 WEST LINN, OR 97068 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $443 | $24 | $467 | 1.64% |
| USI INSURANCE SERVICES LLC3 Filed as: USI NORTHWEST | 700 NE MULTNOMAH, SUITE 1300 PORTLAND, OR 97232 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $166 | $75 | $241 | 0.85% |
| BECKET MOORE WRIGHT3 | PO BOX 2982 CLACKAMAS, OR 97015 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $156 | — | $156 | 0.55% |
| LARRY P HILDEBRANDT3 Filed as: LARRY KENNETH GRIFFIN | 33 NORTH CENTRAL AVENUE, SUITE 429 MEDFORD, OR 97501 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $115 | $19 | $134 | 0.47% |
| USI INSURANCE SERVICES LLC3 Filed as: KIBBLE AND PRENTICE HOLDING COMPANY | 601 UNION STREET, SUITE 1000 SEATTLE, WA 98101 | LIFEMAP ASSURANCE COMPANY | $1K | — | $1K | 7.21% |
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 | 145 | 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) | 145 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HEALTH NET | 145 | $448K |
| Dental | WILLAMETTE DENTAL INSURANCE, INC. | 121 | $39K |
| Vision | LIFEMAP ASSURANCE COMPANY | 184 | $17K |
| Life insurance(2 contracts, 2 carriers) | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 184 | $46K |
| Prescription drug | HEALTH NET | 145 | $448K |
| Other(2 contracts, 2 carriers) | LIFEMAP ASSURANCE COMPANY | 184 | $24K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 184 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.