| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI NORTHWEST | 700 NE MULTNOMAH STE 1300 PORTLAND, OR 97232 | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | $25K | — | $25K | 0.84% |
| MERCER HEALTH AND BENEFITS, LLC3 | 111 SW COLUMBIA STE 500 PORTLAND, OR 97201 | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | $6K | — | $6K | 0.20% |
| USI INSURANCE SERVICES LLC3 Filed as: USI NORTHWEST | 700 NE MULTNOMAH STE 1300 PORTLAND, OR 97232 | PROVIDENCE HEALTH PLAN | $24K | — | $24K | 0.84% |
| MERCER HEALTH AND BENEFITS, LLC3 | 111 SW COLUMBIA STE 500 PORTLAND, OR 97201 | PROVIDENCE HEALTH PLAN | $4K | — | $4K | 0.14% |
| USI INSURANCE SERVICES LLC3 Filed as: USI NORTHWEST | 700 NE MULTNOMAH STREET STE 1300 PORTLAND, OR 97232 | DELTA DENTAL PLAN OF OREGON | $9K | — | $9K | 1.75% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | DELTA DENTAL PLAN OF OREGON | $4K | — | $4K | 0.69% |
| USI INSURANCE SERVICES LLC3 Filed as: USI NORTHWEST | 700 NE MULTNOMAH STE 1300 PORTLAND, OR 97232 | STANDARD INSURANCE COMPANY | $3K | $4K | $8K | 3.10% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | STANDARD INSURANCE COMPANY | $2K | — | $2K | 0.94% |
| USI INSURANCE SERVICES LLC3 Filed as: USI NORTHWEST | 700 NE MULTNOMAH STE 1300 PORTLAND, OR 97232 | STANDARD INSURANCE COMPANY | $5K | $3K | $9K | 4.53% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | STANDARD INSURANCE COMPANY | $530 | — | $530 | 0.27% |
| USI INSURANCE SERVICES LLC3 Filed as: USI NORTHWEST | 700 NE MULTNOMAH STE 1300 PORTLAND, OR 97232 | STANDARD INSURANCE COMPANY | $3K | $2K | $5K | 4.49% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | STANDARD INSURANCE COMPANY | $1K | — | $1K | 1.38% |
| USI INSURANCE SERVICES LLC3 Filed as: USI NORTHWEST | 700 NE MULTNOMAH STE 1300 PORTLAND, OR 97232 | WILLAMETTE DENTAL INSURANCE, INC. | $3K | — | $3K | 3.55% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | WILLAMETTE DENTAL INSURANCE, INC. | $1K | — | $1K | 1.41% |
| USI INSURANCE SERVICES LLC3 Filed as: USI NORTHWEST | 700 NE MULTNOMAH ST STE 1300 PORTLAND, OR 97232 | VISION SERVICE PLAN | $1K | — | $1K | 2.63% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | VISION SERVICE PLAN | $533 | — | $533 | 1.04% |
| HOPING PEOPLE LLC4 Filed as: HOPING PEOPLE, LLC | 9312 SW 153RD AVE BEAVERTON, OR 97007 | PRE-PAID LEGAL SERVICES, INC. | $7K | — | $7K | 31.08% |
| BROWN AND BROWN OF FLORIDA, INC.4 Filed as: MICHAEL D. BROWN | 2215 DORCHESTER DR. S SALEM, OR 97302 | PRE-PAID LEGAL SERVICES, INC. | $32 | — | $32 | 0.15% |
| HOLLY YOES4 | 6009 SW TAYLORS FERRY RD PORTLAND, OR 97219 | PRE-PAID LEGAL SERVICES, INC. | $29 | — | $29 | 0.14% |
| COLLETTE E. FRENCH4 | 12426 SE CARUTHERS ST PORTLAND, OR 97233 | PRE-PAID LEGAL SERVICES, INC. | $11 | — | $11 | 0.05% |
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 | 629 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 5 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 634 | 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 | 416 | $5.7M |
| Dental(2 contracts, 2 carriers) | DELTA DENTAL PLAN OF OREGON | 806 | $592K |
| Vision | VISION SERVICE PLAN | 422 | $51K |
| Life insurance | STANDARD INSURANCE COMPANY | 619 | $101K |
| Short-term disability | STANDARD INSURANCE COMPANY | 619 | $247K |
| Long-term disability | STANDARD INSURANCE COMPANY | 619 | $193K |
| Prescription drug(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | 416 | $5.7M |
| Other(3 contracts, 3 carriers) | STANDARD INSURANCE COMPANY | 619 | $140K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 806 | — |
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.