| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WOODRUFF-SAWYER & CO3 Filed as: WOODRUFF-SAWYER AND COMPANY | 50 CALIFORNIA STREET, 12TH FLOOR SAN FRANCISCO, CA 94111 | REGENCE BLUECROSS BLUESHIELD OF OREGON | $12K | — | $12K | 1.05% |
| WOODRUFF-SAWYER & CO3 Filed as: WOODRUFF-SAWYER AND COMPANY | 50 CALIFORNIA STREET, 12TH FLOOR SAN FRANCISCO, CA 94111 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $42K | $6K | $48K | 7.88% |
| WOODRUFF-SAWYER & CO3 Filed as: WOODRUFF-SAWYER AND COMPANY | 50 CALIFORNIA STREET, 12TH FLOOR SAN FRANCISCO, CA 94111 | METROPOLITAN LIFE INSURANCE COMPANY | $9K | $6K | $14K | 3.03% |
| WOODRUFF-SAWYER & CO3 Filed as: WOODRUFF-SAWYER AND COMPANY | 50 CALIFORNIA STREET, 12TH FLOOR SAN FRANCISCO, CA 94111 | VISION SERVICE PLAN | $2K | — | $2K | 3.27% |
| HEARTSEASE LLC3 Filed as: HEARTSEASE, LLC | 1521 NE 63RD AVENUE HILLSBORO, OR 97124 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $566 | $284 | $850 | 8.42% |
| WOODRUFF-SAWYER & CO3 Filed as: WOODRUFF-SAWYER AND COMPANY | 50 CALIFORNIA STREET, 12TH FLOOR SAN FRANCISCO, CA 94111 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $839 | — | $839 | 8.31% |
| SUSAN J LEACH3 Filed as: SUSAN J. LEACH | 4419 NE 131ST PLACE PORTLAND, OR 97230 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $614 | $64 | $678 | 6.71% |
| BENEFITS BY DESIGN INC3 Filed as: BENEFITS BY DESIGN, INC. | 2101 NE 279TH STREET RIDGEFIELD, WA 98642 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $232 | $97 | $329 | 3.26% |
| PREMIER WORKSITE SOLUTIONS INC3 Filed as: PREMIER WORKSITE SOLUTIONS, INC. | 806 NW 79TH STREET VANCOUVER, WA 98665 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $148 | $112 | $260 | 2.57% |
| MJ INSURANCE3 Filed as: CAROL A. YORK AND VARIOUS AGENTS | 13965 WEST CHINDEN, SUITE 300 BOISE, ID 83706 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $11 | — | $11 | 0.11% |
| CYNTHIA SMART3 | 6977 NORTH PENNCROSS WAY MERIDIAN, ID 83646 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $8 | — | $8 | 0.08% |
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 | 520 | 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) | 528 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | REGENCE BLUECROSS BLUESHIELD OF OREGON | 931 | $1.1M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 1,905 | $479K |
| Vision | VISION SERVICE PLAN | 436 | $63K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 474 | $608K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 474 | $608K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 474 | $608K |
| Prescription drug | REGENCE BLUECROSS BLUESHIELD OF OREGON | 931 | $1.1M |
| Other(3 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 520 | $630K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,905 | — |
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.