| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI NORTHWEST | 700 NE MULTNOMAH, SUITE 1300 PORTLAND, OR 97232 | UNITEDHEALTHCARE INSURANCE COMPANY | — | $52K | $52K | 3.09% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 555 PLEASANTVILLE ROAD BRIARCLIFF MANOR, NY 10510 | STANDARD INSURANCE COMPANY | — | $9K | $9K | 4.00% |
| USI INSURANCE SERVICES LLC3 Filed as: USI NORTHWEST | 700 NE MULTNOMAH, SUITE 1300 PORTLAND, OR 97232 | STANDARD INSURANCE COMPANY | $9K | — | $9K | 3.61% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | PO BOX 62949 VIRGINIA BEACH, VA 23466 | STANDARD INSURANCE COMPANY | $7K | — | $7K | 2.91% |
| USI INSURANCE SERVICES LLC3 Filed as: USI NORTHWEST | 700 NE MULTNOMAH, SUITE 1300 PORTLAND, OR 97232 | VISION SERVICE PLAN | $1K | — | $1K | 5.01% |
| USI INSURANCE SERVICES LLC3 Filed as: USI NORTHWEST | 700 NE MULTNOMAH, SUITE 1300 PORTLAND, OR 97232 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $753 | — | $753 | 8.34% |
| MARGARET BRYANT3 | 18014 SW BELMORE AVENUE LAKE OSWEGO, OR 97035 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $365 | $82 | $447 | 4.95% |
| HEARTSEASE LLC3 Filed as: HEARTSEASE, LLC | 1521 NE 63RD AVENUE HILLSBORO, OR 97124 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $271 | $100 | $371 | 4.11% |
| CHRISTINE LYNN MORGESTER3 | 9405 NE 100TH WAY VANCOIUVER, WA 98662 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $310 | $59 | $369 | 4.09% |
| PREMIER WORKSITE SOLUTIONS INC3 Filed as: PREMIER WORKSITE SOLUTIONS, INC. | 806 NW 79TH STREET VANCOUVER, WA 98665 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $103 | $65 | $168 | 1.86% |
| KAREN CLAY KUNKLER3 | 1709 NW 45TH AVENUE CMAS, WA 98607 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $33 | — | $33 | 0.37% |
| BENEFITS BY DESIGN INC3 Filed as: BENEFITS BY DESIGN, INC. | 2101 NE 279TH STREET RIDGEFIELD, WA 98642 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $21 | $11 | $32 | 0.35% |
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 | 348 | 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) | 348 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITEDHEALTHCARE INSURANCE COMPANY | 400 | $1.7M |
| Dental | STANDARD INSURANCE COMPANY | 348 | $236K |
| Vision | VISION SERVICE PLAN | 196 | $25K |
| Life insurance | STANDARD INSURANCE COMPANY | 348 | $236K |
| Short-term disability | STANDARD INSURANCE COMPANY | 348 | $236K |
| Long-term disability | STANDARD INSURANCE COMPANY | 348 | $236K |
| Prescription drug | UNITEDHEALTHCARE INSURANCE COMPANY | 400 | $1.7M |
| Other(2 contracts, 2 carriers) | STANDARD INSURANCE COMPANY | 348 | $245K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 400 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.