| 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 | REGENCE BLUECROSS BLUESHIELD OF OREGON | $20K | — | $20K | 0.96% |
| USI INSURANCE SERVICES LLC3 Filed as: USI NORTHWEST | 700 NE MULTNOMAH, SUITE 1300 PORTLAND, OR 97232 | REGENCE BLUECROSS BLUESHIELD OF OREGON | $8K | — | $8K | 0.39% |
| USI INSURANCE SERVICES LLC3 Filed as: KIBBLE AND PRENTICE HOLDING COMPANY | 601 UNION STREET, SUITE 1000 SEATTLE, WA 98101 | METROPOLITAN LIFE INSURANCE COMPANY | $3K | $2K | $4K | 3.31% |
| USI INSURANCE SERVICES LLC3 Filed as: USI NORTHWEST | 700 NE MULTNOMAH, SUITE 1300 PORTLAND, OR 97232 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | $758 | $3K | 10.51% |
| HEARTSEASE LLC3 | 1521 NE 63RD AVENUE HILLSBORO, OR 97124 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $474 | $187 | $661 | 6.88% |
| KAREN CLAY KUNKLER3 | 1709 NW 45TH AVENUE CAMAS, WA 98607 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $386 | $64 | $450 | 4.68% |
| USI INSURANCE SERVICES LLC3 Filed as: USI NORTHWEST | 700 NE MULTNOMAH, SUITE 1300 PORTLAND, OR 97232 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $357 | — | $357 | 3.72% |
| BENEFITS BY DESIGN INC3 Filed as: BENEFITS BY DESIGN, INC. | 2101 NE 279TH STREET RIDGEFIELD, WA 98642 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $175 | $66 | $241 | 2.51% |
| PREMIER WORKSITE SOLUTIONS INC3 Filed as: PREMIER WORKSITE SOLUTIONS, INC. | 806 NW 79TH STREET VANCOUVER, WA 98665 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $123 | $79 | $202 | 2.10% |
| MJ INSURANCE3 Filed as: SUSAN J. LEACH AND VARIOUS AGENTS | 4419 NE 131ST PLACE PORTLAND, OR 97230 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $69 | — | $69 | 0.72% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH AND BENEFITS LLC | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60675 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $55 | — | $55 | 0.57% |
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 | 478 | 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) | 478 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | REGENCE BLUECROSS BLUESHIELD OF OREGON | 212 | $2.1M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 386 | $135K |
| Vision | REGENCE BLUECROSS BLUESHIELD OF OREGON | 212 | $2.1M |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 478 | $31K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 478 | $31K |
| Prescription drug | REGENCE BLUECROSS BLUESHIELD OF OREGON | 212 | $2.1M |
| Other(3 contracts, 3 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 478 | $51K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 478 | — |
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.