| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | 1300 SW 5TH AVENUE, SUITE 500 PORTLAND, OR 97201 | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | — | $942 | $942 | 0.02% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | 1300 SW 5TH AVENUE, SUITE 500 PORTLAND, OR 97201 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $12K | $4K | $16K | 8.43% |
| HEARTSEASE LLC3 | 1521 NE 63RD AVENUE HILLSBORO, OR 97124 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $11K | $8K | $20K | 17.90% |
| CHRISTINE LYNN MORGESTER3 Filed as: CHRISTINE MORGESTER AND OTHER AGENT | 137 NORTH Q STREET WASOUQAL, WA 98671 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $9K | $2K | $11K | 10.14% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | 1300 SW 5TH AVENUE, SUITE 500 PORTLAND, OR 97201 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $11K | — | $11K | 9.72% |
| PREMIER WORKSITE SOLUTIONS INC3 | 806 NW 79TH STREET VANCOUVER, WA 98665 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $3K | $4K | $7K | 6.56% |
| BENEFITS BY DESIGN INC3 | 2101 NE 279TH STREET RIDGEFIELD, WA 98642 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $4K | $2K | $7K | 6.01% |
| DARL CORNMAN3 | 18399 SW 133RD TERRACE TUALATIN, OR 97062 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $4K | $592 | $5K | 4.12% |
| ROXANA BUSCHMAN3 | 400 NORTHEAST 149TH STREET VANCOUVER, WA 98685 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $301 | $2K | 2.17% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | 1300 SW 5TH AVENUE, SUITE 500 PORTLAND, OR 97201 | ZURICH AMERICAN INSURANCE COMPANY | $579 | — | $579 | 15.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | 1300 SW 5TH AVENUE, SUITE 500 PORTLAND, OR 97201 | NATIONAL UNION FIRE INSURANCE COMPANY OF PITTSBURGH, PA | $564 | — | $564 | 15.00% |
| MARK J ROBISON3 | 1255 KIENAS ROAD KALISPELL, MT 59901 | THE PAUL REVERE LIFE INSURANCE COMPANY | $34 | — | $34 | 16.04% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | 1300 SW 5TH AVENUE PORTLAND, OR 97201 | THE PAUL REVERE LIFE INSURANCE COMPANY | $22 | — | $22 | 10.38% |
| HEARTSEASE LLC3 Filed as: HEARTSEASE, LLC | 1521 NE 63RD AVENUE HILLSBORO, OR 97124 | THE PAUL REVERE LIFE INSURANCE COMPANY | $1 | — | $1 | 0.47% |
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 | 362 | 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) | 362 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | 838 | $5.2M |
| Vision(3 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | 838 | $5.2M |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 362 | $193K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 362 | $193K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 362 | $193K |
| Prescription drug(3 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | 838 | $5.2M |
| Other(5 contracts, 5 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 362 | $312K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 838 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Multiple-employer welfare arrangement. Specific regulatory and compliance context; specific consultant niche.