| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NORTHWEST | 601 UNION STREET, SUITE 1000 SEATTLE, WA 98101 | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | $32K | $757 | $33K | 1.88% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NORTHWEST | 601 UNION STREET, SUITE 1000 SEATTLE, WA 98101 | KAISER FOUNDATION HEALTH PLAN INC | $56K | $0 | $56K | 3.30% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NORTHWEST | 825 NE MULTNOMAH STREET, SUITE 1500 PORTLAND, OR 97232 | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON OPTIONS, INC. | $28K | $0 | $28K | 2.83% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62949 VIRGINIA BEACH, VA 23466 | RELIASTAR LIFE INSURANCE COMPANY | $8K | $0 | $8K | 6.09% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NORTHWEST | 825 NE MULTNOMAH STREET, SUITE 1500 PORTLAND, OR 97232 | RELIASTAR LIFE INSURANCE COMPANY | $5K | $0 | $5K | 4.15% |
| STEVEN RAY GRIFFIN3 Filed as: STEVEN R. GRIFFIN | 2000 MORRIS AVENUE, APARTMENT 1400 BIRMINGHAM, AL 35203 | RELIASTAR LIFE INSURANCE COMPANY | $966 | $0 | $966 | 0.75% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2000 MORRIS AVENUE, APARTMENT 1400 BRIMINGHAM, AL 35203 | RELIASTAR LIFE INSURANCE COMPANY | $766 | $0 | $766 | 0.59% |
| USI INSURANCE SERVICES LLC3 Filed as: USI SOUTHWEST, INC. | PO BOX 203026 DALLAS, TX 75320 | RELIASTAR LIFE INSURANCE COMPANY | $455 | $0 | $455 | 0.35% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NORTHWEST | 825 NE MULTNOMAH STREET, SUITE 1500 PORTLAND, OR 97232 | LIFEMAP ASSURANCE COMPANY | $1K | $0 | $1K | 11.40% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NORTHWEST | 601 UNION STREET, SUITE 1000 SEATTLE, WA 98101 | LIFEMAP ASSURANCE COMPANY | $237 | $0 | $237 | 2.37% |
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 | 1,191 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 7 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,198 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 4 carriers) | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | 265 | $4.5M |
| Dental(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | 265 | $1.8M |
| Vision(3 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | 265 | $4.5M |
| Life insurance | RELIASTAR LIFE INSURANCE COMPANY | 1,218 | $129K |
| Long-term disability(2 contracts, 2 carriers) | RELIASTAR LIFE INSURANCE COMPANY | 1,218 | $139K |
| Prescription drug(3 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | 265 | $4.5M |
| Other(2 contracts, 2 carriers) | RELIASTAR LIFE INSURANCE COMPANY | 5,740 | $166K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 5,740 | — |
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.