| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PCF INSURANCE SERVICES OF THE WEST3 | 412 JEFFERSON PARKWAY SUITE #203 LAKE OSWEGO, OR 97035 | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | $24K | $700 | $24K | 2.55% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF OR | PO BOX 743061 LOS ANGELES, CA 90074 | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | $8K | — | $8K | 0.88% |
| PCF INSURANCE SERVICES OF THE WEST3 | 412 JEFFERSON PARKWAY SUITE 203 LAKE OSWEGO, OR 97035 | METROPOLITAN LIFE INSURANCE COMPANY | $6K | — | $6K | 4.21% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF OREGON LLC | PO BOX 29018 PORTLAND, OR 97296 | METROPOLITAN LIFE INSURANCE COMPANY | $1K | $384 | $2K | 1.33% |
| PCF INSURANCE SERVICES OF THE WEST3 | — | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $12K | — | $12K | 8.88% |
| WORKSITE BENEFITS GROUP INC3 | 112 NORTHWEST 114TH STREET VANCOUVER, WA 98685 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $6K | $6K | $12K | 8.70% |
| ROXANA BUSCHMAN3 | 400 NORTHEAST 149TH STREET VANCOUVER, WA 98685 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4K | $86 | $4K | 2.99% |
| MELISSA CATHLEEN HADLOCK3 | 14912 NE 249TH ST BATTLE GROUND, WA 98604 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3K | $499 | $3K | 2.22% |
| ISAACSON INSURANCE AGENCY LLC3 | 1250 11TH STREET WEST LINN, OR 97068 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $805 | $3K | 2.07% |
| RAQUEL LOSADA MONROY3 | 817 NORTHEAST DELP ROAD CAMAS, WA 98607 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $335 | $3K | 1.78% |
| MARGARET BRYANT3 | 18014 BELMORE AVE LAKE OSWEGO, OR 97035 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $141 | $2K | 1.24% |
| TY ROBERT NAUGLE3 | PO BOX 80273 PORTLAND, OR 97280 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $214 | $408 | $622 | 0.44% |
| ABIGAIL TAYLOR WEILAND3 | 14511 SW CORNERSTONE LN SHERWOOD, OR 97140 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $197 | $373 | $570 | 0.41% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN AND BROWN OF OREGON LLC | — | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $394 | — | $394 | 0.28% |
| GABRIEL ANGEL CANALS3 | 1549 NW CIVIC DR APT 204 GRESHAM, OR 97030 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $150 | $243 | $393 | 0.28% |
| DAVID KINNEY3 | 802 NEVADA DRIVE LONGVIEW, WA 98632 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $75 | — | $75 | 0.05% |
| ANDREW ERIC STEELE3 | 8101 NE 152ND AVE VANCOUVER, WA 98682 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $75 | — | $75 | 0.05% |
| BENEFITS BY DESIGN INC3 | 2101 NORTHEAST 279TH STREET RIDGEFIELD, WA 98642 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $53 | $18 | $71 | 0.05% |
| JOHN WEY CURRY3 | 12712 NE 103RD ST VANCOUVER, WA 98682 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $13 | $41 | $54 | 0.04% |
| KENNETH E HADLOCK3 | 14912 NE 249TH ST BATTLE GROUND, WA 98604 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $30 | — | $30 | 0.02% |
| ZINA OSTER3 | 3153 FOREST DRIVE CHEYENNE, WY 82001 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $21 | — | $21 | 0.01% |
| MARCI TALBURT3 | 4721 AZALEA GLEN RD GLENDALE, OR 97442 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $10 | $5 | $15 | 0.01% |
| HEARTSEASE LLC3 | 1521 NE 63RD AVE HILLSBORO, OR 97124 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4 | $2 | $6 | 0.00% |
| SUSAN J LEACH3 | 4419 NE 103RD ST VANCOUVER, WA 97230 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.00% |
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 | 232 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 233 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | 187 | $955K |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 370 | $141K |
| Life insurance(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 370 | $282K |
| Other(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 370 | $282K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 370 | — |
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.