| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | 777 108TH AVENUE NE, SUITE 200 BELLEVUE, WA 98004 | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | $32K | $509 | $33K | 2.52% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 777 108TH AVENUE NW, SUITE 200 BELLEVUE, WA 98004 | REGENCE BLUESHIELD | $30K | $3K | $33K | 3.26% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 777 108TH AVENUE NE, SUITE 200 BELLEVUE, WA 98004 | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON | $10K | $0 | $10K | 2.18% |
| BENEFITS BY DESIGN INC3 Filed as: BENEFITS BY DESIGN, INC. | 2101 NE 279TH STREET RIDGEFIELD, WA 98642 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $13K | $5K | $18K | 8.95% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 777 108TH AVENUE NE, SUITE 200 BELLEVUE, WA 98004 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $16K | $552 | $16K | 8.02% |
| WORKSITE BENEFITS GROUP INC3 Filed as: WORKSITE BENEFITS GROUP, INC. | 112 NW 114TH STREET VANCOUVER, WA 98685 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $3K | $4K | $7K | 3.33% |
| MELISSA CATHLEEN HADLOCK3 | 14912 NE 249TH STREET BATTLE GROUND, WA 98604 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $5K | $567 | $6K | 2.89% |
| MJ INSURANCE3 Filed as: ZARA ANNE PINES AND VARIOUS AGENTS | 9010 SW OAK STREET, SUITE 300A PORTLAND, OR 97223 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $3K | $717 | $4K | 1.75% |
| SUSAN J LEACH3 Filed as: SUSAN J. LEACH | 4419 NE 131ST PLACE, SUITE C1 PORTLAND, OR 97230 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $84 | $2K | 1.15% |
| PAMELA COPLE SMITH3 | 411 HIGHLAND DRIVE SEATTLE, WA 98109 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $0 | $2K | 0.93% |
| UNKNOWN3 | UNKNOWN LONGVIEW, WA 98632 | DELTA DENTAL OF WASHINGTON | $9K | — | $9K | 5.01% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 777 108TH AVENUE NE, SUITE 200 BELLEVUE, WA 98004 | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON OPTIONS, INC. | $3K | $0 | $3K | 2.17% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 777 108TH AVENUE NE, SUITE 200 BELLEVUE, WA 98004 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | $0 | $5K | 8.12% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 736 SOUTH STONE AVENUE LA GRANGE, IL 60525 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $3K | $3K | 4.48% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 777 108TH AVENUE NE, SUITE 200 BELLEVUE, WA 98004 | WILLAMETTE DENTAL OF WASHINGTON, INC. | $3K | $0 | $3K | 5.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 777 108TH AVENUE NE, SUITE 200 BELLEVUE, WA 98004 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $17 | $1K | 4.77% |
| BENEFITS BY DESIGN INC3 Filed as: BENEFITS BY DESIGN, INC. | 2101 NE 279TH STREET RIDGEFIELD, WA 98642 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $564 | $149 | $713 | 3.25% |
| WORKSITE BENEFITS GROUP INC3 Filed as: WORKSITE BENEFITS GROUP, INC. | 112 NW 114TH STREET VANCOUVER, WA 98685 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $228 | $129 | $357 | 1.63% |
| ZARA ANNE PINES3 Filed as: ZARA ANNE PINES AND OTHER AGENTS | 9010 SW OAK STREET APARTMENT 300A PORTLAND, OR 97223 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $275 | $18 | $293 | 1.33% |
| SUSAN J LEACH3 Filed as: SUSAN J. LEACH | 4419 NE 131ST PLACE, APARTMENT C1 PORTLAND, OR 97230 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $171 | $7 | $178 | 0.81% |
| PCF INSURANCE SERVICES OF THE WEST3 | UNKNOWN LAKE OSWEGO, OR 97035 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $162 | $0 | $162 | 0.74% |
| KAREN CLAY KUNKLER3 | 415 SE 177TH AVENUE, UNIT 236 VANCOUVER, WA 98683 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $148 | $0 | $148 | 0.67% |
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 | 554 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 6 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 560 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 4 carriers) | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | 197 | $2.9M |
| Dental(2 contracts, 2 carriers) | DELTA DENTAL OF WASHINGTON | 396 | $248K |
| Vision | REGENCE BLUESHIELD | 135 | $1.0M |
| Life insurance(3 contracts, 2 carriers) | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 554 | $291K |
| Short-term disability(2 contracts) | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 286 | $224K |
| Long-term disability(2 contracts) | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 286 | $224K |
| Prescription drug(4 contracts, 4 carriers) | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | 197 | $2.9M |
| Other(3 contracts, 2 carriers) | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 554 | $291K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 554 | — |
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."
No prospect flags tripped on this filing.