| 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 | $22K | $74 | $22K | 3.03% |
| MONTGOMERY & GRAHAM INC3 | 412 JEFFERSON PKWY STE 100 LAKE OSWEGO, OR 97035 | METROPOLITAN LIFE INSURANCE COMPANY | $7K | $27 | $7K | 5.93% |
| POLESTAR BENEFITS INC3 Filed as: POLESTAR BENEFITS INC. | 412 JEFFERSON PKWY STE 202 LAKE OSWEGO, OR 97035 | METROPOLITAN LIFE INSURANCE COMPANY | $301 | — | $301 | 0.27% |
| PREMIER WORKSITE SOLUTIONS INC3 | 112 NW 114TH ST VANCOUVER, WA 98685 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $5K | $4K | $10K | 13.54% |
| MONTGOMERY & GRAHAM INC3 Filed as: MONTGOMERY AND GRAHAM INC | 412 JEFFERSON PKWY LAKE OSWEGO, OR 97035 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $7K | $251 | $8K | 10.84% |
| ROXANA BUSCHMAN3 | 400 NORTHEAST 149TH STREET VANCOUVER, WA 98685 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4K | $105 | $4K | 6.39% |
| ISAACSON INSURANCE AGENCY LLC3 | 1250 11TH STREET WEST LINN, OR 97068 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $752 | $3K | 4.17% |
| MARGARET BRYANT3 | 18014 SW BELMORE AVE LAKE OSWEGO, OR 97035 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $260 | $1K | 1.92% |
| RAQUEL LOSADA MONROY3 Filed as: RAQUEL LOSADA MMONROY | 817 NE DELP ROAD CAMAS, WA 98607 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $777 | $165 | $942 | 1.34% |
| JULIE WOLDEN3 | 2231 LARCH ST LONGVIEW, WA 98632 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $791 | $78 | $869 | 1.24% |
| GABRIEL ANGEL CANALS3 | 1329 NE 236TH AVE WOOD VILLAGE, OR 97060 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $58 | $107 | $165 | 0.24% |
| PAUL J LANGAS3 Filed as: PAUL SWEANY | 715 W FOURTH PLAIN BLVD VANCOUVER, WA 98660 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $47 | — | $47 | 0.07% |
| BENEFITS BY DESIGN INC3 Filed as: BENEFITS BY DESIGN | 2101 NE 279TH ST RIDGEFILED, WA 98642 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $43 | — | $43 | 0.06% |
| ZINA OSTER3 | 3153 FOREST DR CHEYENNE, WY 82001 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $34 | — | $34 | 0.05% |
| SUSAN J LEACH3 | 4419 NE 131ST PLACE PORTLAND, OR 97230 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $8 | — | $8 | 0.01% |
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 | 152 | 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) | 152 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | 152 | $737K |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 311 | $111K |
| Life insurance(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 311 | $181K |
| Other(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 311 | $181K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 311 | — |
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 compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.