| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE INC. | 200 GALLERIA PARKWAY ST. SUITE 1950 ATLANTA, GA 303395946 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $29K | — | $29K | 7.05% |
| ASSUREDPARTNERS3 Filed as: ASSURED PARTNERS OF OREGON | 941 OAK STREET EUGENE, OR 97401 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $18K | — | $18K | 4.42% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCES LLC | 200 GALLERIA PKWY SE STE 1950 STE 1650 ATLANTA, GA 30339 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $8K | $5K | $13K | 8.91% |
| PREMIER WORKSITE SOLUTIONS INC3 | 112 NORTHWEST 114TH STREET VANCOUVER, WA 98685 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $1K | $3K | 13.85% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE INC. | 200 GALLERIA PARKWAY ST. SUITE 1950 ATLANTA, GA 303395946 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $382 | $2K | 7.27% |
| PROPEL INSURANCE AGENCY LLC3 | NO STREET ADDRESS TACOMA, WA 98402 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $753 | — | $753 | 3.29% |
| BENEFITS BY DESIGN INC3 | 2101 NORTHEAST 279TH STREET RIDGEFIELD, WA 98642 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $423 | $180 | $603 | 2.64% |
| ISAACSON INSURANCE AGENCY LLC3 | 1250 11TH STREET WEST LINN, OR 97068 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $252 | $49 | $301 | 1.32% |
| PAMELA COPLE SMITH3 | 411 HIGHLAND DRIVE SEATTLE, WA 98109 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $202 | $39 | $241 | 1.05% |
| DONALD C SAVOY INC3 Filed as: DONALD TERRY GOTHAM | 3129 ECLIPSE DRIVE GREEN BAY, WI 54311 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $60 | — | $60 | 0.26% |
| ASSUREDPARTNERS3 Filed as: ASSUREDPARTNERS OF OREGON LLC | 941 OAK STREET EUGENE, OR 97401 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $47 | — | $47 | 0.21% |
| JOEL N NEWMAN AGENCY LLC3 | 924-B NW 52ND STREET SEATTLE, WA 98107 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $30 | $10 | $40 | 0.17% |
| KAREN CLAY KUNKLER3 | 1709 NORTHWEST 45TH AVENUE CAMAS, WA 98607 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $33 | — | $33 | 0.14% |
| ZINA OSTER3 | 3153 FOREST DRIVE CHEYENNE, WY 82001 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $32 | — | $32 | 0.14% |
| HEARTSEASE LLC3 | 1521 NORTHEAST 63RD AVENUE HILLSBORO, OR 97124 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $15 | $7 | $22 | 0.10% |
| MICHAEL LEROY ALLEY3 | 5285 MEADOWS ROAD #370 LAKE OSWEGO, OR 97035 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $8 | $8 | $16 | 0.07% |
| CHRISTINE LYNN MORGESTER3 | 14913 S SUNTERRA LOOP OREGON CITY, OR 97045 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $11 | — | $11 | 0.05% |
| ROXANA BUSCHMAN3 | 400 NORTHEAST 149TH STREET VANCOUVER, WA 98685 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $5 | — | $5 | 0.02% |
| QUEST BENEFITS NORTHWEST LLC3 Filed as: QUEST BENEFITS NORTHWEST | 5285 MEADOWS ROAD #370 LAKE OSWEGO, OR 97035 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | — | $3 | $3 | 0.01% |
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 | 165 | 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) | 165 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 118 | $407K |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 177 | $146K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 177 | $146K |
| Life insurance | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 28 | $23K |
| Prescription drug | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 118 | $407K |
| Other | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 28 | $23K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 177 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.