| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PREMIER WORKSITE SOLUTIONS INC3 Filed as: PREMIER WORKSITE SOLUTIONS, INC. | 806 NW 79TH STREET VANCOUVER, WA 98665 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $3K | $2K | $5K | 4.04% |
| LUIS EDUARDO CARDENAS3 | PO BOX 1983 ISSAQUAH, WA 98027 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $4K | $696 | $5K | 3.66% |
| USI INSURANCE SERVICES LLC3 Filed as: KIBBLE AND PRENTICE HOLDING COMPANY | 601 UNION STREET, SUITE 1000 SEATTLE, WA 98101 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $4K | $526 | $4K | 3.14% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: PAYNEWEST INSURANCE, INC. | PO BOX 789 ALBANY, OR 97321 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $4K | — | $4K | 2.85% |
| BENEFITS BY DESIGN INC3 Filed as: BENEFITS BY DESIGN AND OTHER AGENTS | 2101 NE 279TH STREET RIDGEFIELD, WA 98642 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $3K | $687 | $4K | 2.82% |
| PATRICK IAN WAGNER3 | 4580 PEBBLE BROOK LANE PLANO, TX 75093 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $3K | — | $3K | 2.23% |
| JOEL N NEWMAN AGENCY LLC3 Filed as: JOEL N. NEWMAN AGENCY, INC. | 7808 SE 28TH STREET MERCER ISLAND, WA 98040 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $1K | $3K | 2.16% |
| USI INSURANCE SERVICES LLC3 Filed as: KIBBLE AND PRENTICE HOLDING COMPANY | 601 UNION STREET, SUITE 1000 SEATTLE, WA 98101 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $426 | $142 | $568 | 20.01% |
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 | 204 | 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) | 204 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance(2 contracts, 2 carriers) | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 204 | $133K |
| Short-term disability | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 122 | $130K |
| Other(2 contracts, 2 carriers) | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 204 | $133K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 204 | — |
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 compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.