| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | 1300 SOUTHWEST 5TH AVENUE SUITE 500 PORTLAND, OR 97201 | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | $0 | $1 | $1 | 0.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | 1300 SOUTHWEST 5TH AVENUE SUITE 500 PORTLAND, OR 97201 | LIFE INSURANCE COMPANY OF NORTH AME | $12K | $0 | $12K | 5.10% |
| HEARTSEASE LLC3 | 1521 NE 63RD AVENUE HILLSBORO, OR 97124 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $13K | $10K | $23K | 12.83% |
| WELLS FARGO INSURANCE SERVICES3 | 1300 SW 5TH AVENUE PORTLAND, OR 97201 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $12K | $0 | $12K | 6.72% |
| KAREN CLAY KUNKLER3 Filed as: KAREN JUNKLER AND OTHER AGENTS | 1709 NW 45TH AVENUE CAMAS, WA 98607 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $10K | $1K | $11K | 6.20% |
| BENEFITS BY DESIGN INC3 Filed as: BENEFITS BY DESIGN INC. | 2101 NE 279TH STREET RIDGEFIELD, WA 98642 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $5K | $2K | $7K | 3.86% |
| PREMIER WORKSITE SOLUTIONS INC3 Filed as: PREMIER WORKSITE SOLUTIONS INC. | 112 NW 114TH STREET VANCOUVER, WA 98685 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $4K | $2K | $6K | 3.47% |
| DARL CORNMAN3 | 18399 SW 133RD TERRACE TUALATIN, OR 97062 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $4K | $443 | $4K | 2.48% |
| DEREK THURSTON3 | 112 NW 114TH STREET VANCOUVER, WA 98685 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $17 | $2K | 1.37% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | 1300 SOUTH WEST FIFTH AVENUE, SUITE PORTLAND, OR 97201 | ZURICH AMERICAN INSURANCE COMPANY | $578 | $0 | $578 | 15.00% |
| MARK J ROBISON3 | 1255 KIENAS ROAD KALISPELL, MT 59901 | PAUL REVERE | $11 | $0 | $11 | 4.33% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | 1300 SW 5TH AVENUE PORTLAND, OR 97201 | PAUL REVERE | $10 | $0 | $10 | 3.94% |
| BENEFITS BY DESIGN INC3 | 2101 NE 279TH STREET RIDGEFIELD, WA 98642 | PAUL REVERE | $1 | $0 | $1 | 0.39% |
| PREMIER WORKSITE SOLUTIONS INC3 | 112 NW 114TH STREET VANCOUVER, WA 98685 | PAUL REVERE | $1 | $0 | $1 | 0.39% |
| HEARTSEASE LLC3 Filed as: HEARTSEASE | 1521 NE 63RD AVENUE HILLSBORO, OR 97124 | PAUL REVERE | $1 | $0 | $1 | 0.39% |
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)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | 859 | $5.1M |
| Vision(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | 859 | $5.1M |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AME | 362 | $245K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AME | 362 | $245K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AME | 362 | $245K |
| Prescription drug(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | 859 | $5.1M |
| Other(5 contracts, 5 carriers) | LIFE INSURANCE COMPANY OF NORTH AME | 362 | $425K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 859 | — |
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.
Multiple-employer welfare arrangement. Specific regulatory and compliance context; specific consultant niche.