| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARGARET BRYANT3 | 18014 BELMORE AVENUE LAKE OSWEGO, OR 97035 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $13K | $876 | $14K | 12.25% |
| WORKSITE BENEFITS GROUP INC3 Filed as: WORKSITE BENEFITS GROUP, INC. | 112 NW 114TH STREET VANCOUVER, WA 98685 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $4K | $8K | $12K | 10.63% |
| DONALD H. MATSON & OTHER AGENTS3 | 8 ROSEWOOD DRIVE AUBURN, NY 13201 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $9K | $1K | $10K | 8.88% |
| PAYCHEX INSURANCE AGENCY, INC.3 | 225 KENNETH DRIVE ROCHESTER, NY 14623 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $9K | $0 | $9K | 7.97% |
| CAROLE H WARREN3 Filed as: CAROLE H. WARREN | 2716 HANOVER CIRCLE SOUTH APARTMENT 801 BIRMINGHAM, AL 35205 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $3K | $2K | $5K | 4.35% |
| CHRISTINE LYNN MORGESTER3 | 14913 SOUTH SUNTERRA LOOP OREGON CITY, OR 97045 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $4K | $272 | $4K | 3.82% |
| ISAACSON INSURANCE AGENCY LLC3 Filed as: ISAACSON INSURANCE AGENCY, LLC | 1250 11TH STREET WEST LINN, OR 97068 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $3K | $1K | $4K | 3.80% |
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 | 0 | 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) | 0 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 133 | $115K |
| Short-term disability | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 133 | $115K |
| Other | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 133 | $115K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 133 | — |
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.
Final-filing indicator set. Plan is winding down; don't waste sales effort here.