| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: KIBBLE & PRENTICE HOLDING COMPANY | 601 UNION ST. 1000 SEATTLE, WA 98101 | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | — | $70 | $70 | 0.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| THE WILLIAM C. EARHART CO., INC. EIN 93-0509592 THIRD PARTY ADMINISTRATOR | Claims processing; Plan Administrator; Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | PO BOX 4148 PORTLAND, OR 97208 | $131K |
| LINDQUIST LLP EIN 52-2385296 PAYROLL AUDITOR | Accounting (including auditing) Service code 10 | 5000 EXECUTIVE PKWY S 400 SAN RAMON, CA 94583 | $54K |
| USI INSURANCE SERVICES EIN 56-1882208 PLAN CONSULTANT | Consulting (general) Service code 16 | 1300 SW 5TH AVE STE 500 PORTLAND, OR 97201 | $48K |
| BROWNSTEIN RASK, LLP EIN 93-0589000 LEGAL COUNSEL | Legal Service code 29 | 1200 SW MAIN STREET PORTLAND, OR 97205 | $25K |
| BJORKLUND & MONTPLAISIR EIN 93-1015766 PLAN AUDITOR | Accounting (including auditing) Service code 10 | 9020 SW WASHINGTON SQ RD PORTLAND, OR 97223 | $14K |
| U.S. BANK NATIONAL ASSOCIATION EIN 31-0841368 BANKING & INVEST CUSTODY | Other services; Custodial (securities) Service code 19 | 900 SW 6TH AVE. PORTLAND, OR 97204 | $11K |
| JH HERRLE & ASSOC. INSURANCE, INC. EIN 93-0692196 INSURANCE BROKER | Insurance agents and brokers Service code 22 | 1800 SW 1ST AVE STE 280 PORTLAND, OR 97201 | $0 |
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 | 1,323 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 8 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,331 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | 2,219 | $14.6M |
| Dental | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | 2,219 | $14.6M |
| Vision | VISION SERVICE PLAN | 1,879 | $61K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | 2,219 | $14.6M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,219 | — |
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."
Broker comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.