| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HECHT & HECHT LIFE & HEALTH INS3 Filed as: HECHT & HECHT LIFE & HEALTH INS. | 425 NE HANCOCK STREET PORTLAND, OR 97212 | PREMERA BLUE CROSS | $18K | $2K | $20K | 2.99% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE, INC. | 200 GALLERIA PARKWAY SE, SUITE 1950 ATLANTA, GA 30339 | PREMERA BLUE CROSS | $2K | $0 | $2K | 0.25% |
| HECHT & HECHT LIFE & HEALTH INS3 Filed as: HECHT & HECHT LIFE & HEALTH INS. | 425 NE HANCOCK STREET PORTLAND, OR 97212 | AMERITAS LIFE INSURANCE CORP. | $4K | $0 | $4K | 3.82% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE, INC. | 200 GALLERIA PARKWAY SE, SUITE 1950 ATLANTA, GA 30339 | AMERITAS LIFE INSURANCE CORP. | $217 | $0 | $217 | 0.19% |
| ALLIANT INSURANCE SERVICES, INC.3 | 425 NE HANCOCK STREET PORTLAND, OR 97212 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $7K | $0 | $7K | 14.57% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE, INC. | 200 GALLERIA PARKWAY SE, SUITE 1950 ATLANTA, GA 30339 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $759 | $273 | $1K | 2.21% |
| HECHT & HECHT LIFE & HEALTH INS3 Filed as: HECHT & HECHT LIFE & HEALTH INS. | 425 NE HANCOCK STREET PORTLAND, OR 97212 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3K | $0 | $3K | 10.07% |
| MARGARET BRYANT3 | 18014 SW BELMORE AVENUE LAKE OSWEGO, OR 97035 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $357 | $2K | 8.91% |
| DONALD C SAVOY INC3 Filed as: DONALD TERRY GOTHAM | 4009 NORTH 9TH STREET TACOMA, WA 98406 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $23 | $1K | 4.48% |
| LISA LOUISE ROBBERSON3 | 13120 102ND LANE NE, SUITE 3 KIRKLAND, WA 98034 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $658 | $43 | $701 | 2.64% |
| PREMIER WORKSITE SOLUTIONS INC3 Filed as: PREMIER WORKSITE SOLUTIONS, INC. | 806 NW 279TH STREET RIDGEFIELD, WA 98642 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $364 | $245 | $609 | 2.29% |
| MJ INSURANCE3 Filed as: BRIAN RODERICK AND VARIOUS AGENTS | 3104 MCALLISTER STREET DUPONT, WA 98327 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $317 | $266 | $583 | 2.20% |
| BENEFITS BY DESIGN INC3 Filed as: BENEFITS BY DESIGN, INC. | 2101 NE 279TH STREET RIDGEFIELD, WA 98642 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $111 | $0 | $111 | 0.42% |
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 | 153 | 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) | 153 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | PREMERA BLUE CROSS | 153 | $664K |
| Dental | AMERITAS LIFE INSURANCE CORP. | 281 | $115K |
| Vision | AMERITAS LIFE INSURANCE CORP. | 281 | $115K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 189 | $47K |
| Short-term disability | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 29 | $27K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 189 | $47K |
| Prescription drug | PREMERA BLUE CROSS | 153 | $664K |
| Other(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 189 | $73K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 281 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.