| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: KIBBLE & PRENTICE HOLDING COMPANY | 601 UNION STREET, SUITE 1000 SEATTLE, WA 98101 | PROVIDENCE HEALTH PLAN | $24K | $0 | $24K | 2.06% |
| K.P.D. INSURANCE, LLC3 Filed as: K.P.D INSURANCE LLC | 10260 SW GREENBURG ROAD SUITE 550 PORTLAND, OR 97223 | PROVIDENCE HEALTH PLAN | $8K | $0 | $8K | 0.69% |
| USI INSURANCE SERVICES LLC3 Filed as: KIBBLE & PRENTICE HOLDING COMPANY | PO BOX 62949 VIRGINA BEACH, VA 23466 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $5K | $0 | $5K | 6.57% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62889 VIRGINA BEACH, VA 23466 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $0 | $4K | $4K | 5.70% |
| K.P.D. INSURANCE, LLC3 Filed as: K.P.D INSURANCE LLC | PO BOX 784 SPRINGFIELD, OR 97477 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $1K | $0 | $1K | 1.96% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62949 VIRGINA BEACH, VA 23466 | WILLAMETTE DENTAL INSURANCE, INC. | $994 | $0 | $994 | 3.20% |
| K.P.D. INSURANCE, LLC3 Filed as: K.P.D INSURANCE LLC | PO BOX 784 SPRINGFIELD, OR 97477 | WILLAMETTE DENTAL INSURANCE, INC. | $560 | $0 | $560 | 1.80% |
| USI INSURANCE SERVICES LLC3 Filed as: KIBBLE & PRENTICE HOLDING COMPANY | PO BOX 62949 VIRGINA BEACH, VA 23466 | VISION SERVICE PLAN | $746 | $0 | $746 | 5.84% |
| K.P.D. INSURANCE, LLC3 Filed as: K.P.D INSURANCE LLC | PO BOX 784 SPRINGFIELD, OR 97477 | VISION SERVICE PLAN | $142 | $0 | $142 | 1.11% |
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 | 175 | 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) | 175 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | PROVIDENCE HEALTH PLAN | 251 | $1.2M |
| Dental(2 contracts, 2 carriers) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 175 | $101K |
| Vision | VISION SERVICE PLAN | 134 | $13K |
| Life insurance | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 175 | $70K |
| Prescription drug | PROVIDENCE HEALTH PLAN | 251 | $1.2M |
| Other | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 175 | $70K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 251 | — |
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.