| 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 | $30K | $489 | $30K | 2.33% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 777 108TH AVENUE NE, SUITE 200 BELLEVUE, WA 98004 | REGENCE BLUESHIELD | $28K | $5K | $33K | 3.50% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 777 108TH AVENUE NE, SUITE 200 BELLEVUE, WA 98004 | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON | $10K | $0 | $10K | 2.69% |
| BENEFITS BY DESIGN INC3 Filed as: BENEFITS BY DESIGN, INC. | 2101 NE 279TH STREET RIDGEFIELD, WA 98641 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $13K | $5K | $18K | 9.53% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 777 108TH AVENUE NE, SUITE 200 BELLEVUE, WA 98004 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $15K | $31 | $15K | 8.22% |
| WORKSITE BENEFITS GROUP INC3 Filed as: WORKSITE BENEFITS GROUP, INC. | 112 NW 114TH STREET VANCOUVER, WA 98685 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $3K | $3K | $6K | 3.16% |
| MELISSA CATHLEEN HADLOCK3 | 14912 NE 249TH STREET BATTLE GROUND, WA 98604 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $4K | $716 | $5K | 2.58% |
| PAMELA COPLE SMITH3 | 411 HIGHLAND DRIVE SEATTLE, WA 98109 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $4K | $115 | $4K | 2.32% |
| KAREN CLAY KUNKLER3 Filed as: KAREN CLAY KUNKLER AND OTHER AGENTS | 415 SE 177TH AVENUE, SUITE 236 VANCOUVER, WA 98683 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $914 | $3K | 1.81% |
| ZARA ANNE PINES3 | 9010 SW OAK STREET, SUITE 300A PORTLAND, OR 97223 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $0 | $1K | 0.64% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 777 108TH AVENUE NE, SUITE 200 BELLEVUE, WA 98004 | DELTA DENTAL OF WASHINGTON | $9K | $0 | $9K | 5.00% |
| 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 | 2.73% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 777 108TH AVENUE NE, SUITE 200 BELLEVUE, WA 98004 | WILLAMETTE DENTAL OF WASHINGTON, INC. | $3K | $0 | $3K | 4.59% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 959 11TH AVENUE, SUITE B LONGVIEW, WA 98632 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $0 | $4K | 7.52% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 736 SOUTH STONE AVENUE LA GRANGE, IL 60525 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $2K | $2K | 2.81% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 777 108TH AVENUE NE, SUITE 200 BELLEVUE, WA 98004 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $1 | $1K | 5.25% |
| BENEFITS BY DESIGN INC3 Filed as: BENEFITS BY DESIGN, INC. | 2101 NE 279TH STREET RIDGEFIELD, WA 98641 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $653 | $189 | $842 | 3.91% |
| 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 | $339 | $52 | $391 | 1.82% |
| WORKSITE BENEFITS GROUP INC3 Filed as: WORKSITE BENEFITS GROUP, INC. | 112 NW 114TH STREET VANCOUVER, WA 98685 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $241 | $111 | $352 | 1.64% |
| MELISSA CATHLEEN HADLOCK3 | 14912 NE 249TH STREET BATTLE GROUND, WA 98604 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $208 | $36 | $244 | 1.13% |
| KAREN CLAY KUNKLER3 | 415 SE 177TH AVENUE, SUITE 236 VANCOUVER, WA 98683 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $196 | $0 | $196 | 0.91% |
| PCF INSURANCE SERVICES OF THE WEST3 | UNKNOWN LAKE OSWEGO, OR 97035 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $164 | $0 | $164 | 0.76% |
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 | 303 | 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) | 303 | 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 | 208 | $2.7M |
| Dental(2 contracts, 2 carriers) | DELTA DENTAL OF WASHINGTON | 410 | $244K |
| Vision | REGENCE BLUESHIELD | 137 | $935K |
| Life insurance(3 contracts, 2 carriers) | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 310 | $265K |
| Short-term disability(2 contracts) | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 310 | $208K |
| Long-term disability(2 contracts) | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 310 | $208K |
| Prescription drug(4 contracts, 4 carriers) | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | 208 | $2.7M |
| Other(3 contracts, 2 carriers) | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 310 | $265K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 410 | — |
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.