| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MONTGOMERY & GRAHAM INC3 Filed as: MONTGOMERY & GRAHAM, INC. | 412 JEFFERSON PKWY #100 LAKE OSWEGO, OR 97035 | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | $21K | $786 | $21K | 3.13% |
| MONTGOMERY & GRAHAM INC3 | 412 JEFFERSON PKWY STE 100 LAKE OSWEGO, OR 97035 | METROPOLITAN LIFE INSURANCE COMPANY | $6K | $27 | $6K | 6.12% |
| POLESTAR BENEFITS INC3 Filed as: POLESTAR BENEFITS INC. | 412 JEFFERSON PKWY STE 202 LAKE OSWEGO, OR 97035 | METROPOLITAN LIFE INSURANCE COMPANY | $298 | — | $298 | 0.28% |
| MONTGOMERY & GRAHAM INC3 Filed as: MONTGOMERY AND GRAHAM INC | 412 JEFFERSON PKWY LAKE OSWEGO, OR 97035 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3K | $68 | $3K | 9.42% |
| PREMIER WORKSITE SOLUTIONS INC3 Filed as: PREMIER WORKSITE SOLUTIONS, INC. | 112 NW 114TH ST VANCOUVER, WA 98685 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $593 | $2K | 6.07% |
| ROXANA BUSCHMAN3 | 400 NORHTEAST 149TH STREET VANCOUVER, WA 98685 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $85 | $1K | 4.64% |
| MARGARET BRYANT3 | 18014 SW BELMORE AVE LAKE OSWEGO, OR 97035 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $46 | $15 | $61 | 0.22% |
| PAUL J LANGAS3 Filed as: PAUL SWEANY | 718 W FOURTH PLAIN BLVD VANCOUVER, WA 98660 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $56 | — | $56 | 0.20% |
| BENEFTIS BY DESIGN INC3 | 2101 NE 279TH ST RIDGEFIELD, WA 98642 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $37 | — | $37 | 0.13% |
| ZINA OSTER3 | 3153 FOREST DR CHEYENNE, WY 82001 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $31 | — | $31 | 0.11% |
| SUSAN J LEACH3 | 4419 NE 131ST PLACE PORTLAND, OR 97230 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $7 | — | $7 | 0.03% |
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 | 145 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 145 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | 145 | $686K |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 298 | $106K |
| Life insurance(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 298 | $134K |
| Other(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 298 | $134K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 298 | — |
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.