| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | PO BOX 62949 VIRGINIA BEACH, VA 23466 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $19K | $0 | $19K | 7.37% |
| HEARTSEASE LLC3 Filed as: HEARTSEASE, LLC | 1521 NE 63RD AVENUE HILLSBORO, OR 97124 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $3K | $885 | $4K | 4.93% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NORTHWEST | 825 NE MULTNOMAH STREET, SUITE 1500 PORTLAND, OR 97232 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $3K | $59 | $3K | 3.38% |
| WORKSITE BENEFITS GROUP INC3 Filed as: WORKSITE BENEFITS GROUP, INC. | 112 NW 114TH STREET VANCOUVER, WA 98685 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $795 | $451 | $1K | 1.64% |
| BENEFITS BY DESIGN INC3 Filed as: BENEFITS BY DESIGN, INC. | 2101 NE 279TH STREET RIDGEFIELD, WA 98642 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $974 | $176 | $1K | 1.51% |
| ISAACSON INSURANCE AGENCY LLC3 Filed as: ISAACSON INS AGCY, LLC & AGENTS | 1250 11TH STREET WEST LINN, OR 97068 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $852 | $171 | $1K | 1.35% |
| KAREN CLAY KUNKLER3 | 415 SE 177TH AVENUE, UNIT 236 VANCOUVER, WA 98683 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $990 | $6 | $996 | 1.31% |
| SUSAN GOLD STOKES3 | 104 MISTY HOLLOW WAY HUNTSVILLE, AL 35806 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $556 | $80 | $636 | 0.84% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NORTHWEST | 825 NE MULTNOMAH STREET, SUITE 1500 PORTLAND, OR 97232 | ZURICH AMERICAN INSURANCE COMPANY | $276 | $0 | $276 | 14.99% |
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 | 618 | 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) | 618 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | 741 | $6.6M |
| Vision(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | 741 | $5.7M |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 618 | $263K |
| Short-term disability(3 contracts, 3 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 618 | $339K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 618 | $263K |
| Prescription drug(3 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | 741 | $6.6M |
| Other(6 contracts, 6 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 618 | $353K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 741 | — |
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 comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.
Multiple-employer welfare arrangement. Specific regulatory and compliance context; specific consultant niche.