| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ALLIANT INSURANCE SERVICES, INC.3 | 105 WEST EVERGREEN BOULEVARD SUITE 200 VANCOUVER, WA 98660 | PRINCIPAL LIFE INSURANCE COMPANY | $11K | — | $11K | 5.76% |
| HEARTSEASE LLC3 Filed as: HEARTSEASE, LLC | 1521 NE 63RD AVENUE HILLSBORO, OR 97124 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $6K | $3K | $9K | 10.84% |
| ALLIANT INSURANCE SERVICES, INC.3 | PO BOX 189 VANCOUVER, WA 98666 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $5K | $1K | $6K | 7.32% |
| WORKSITE BENEFITS GROUP INC3 Filed as: WORKSITE BENEFITS GROUP, INC. | 112 NW 114TH STREET VANCOUVER, WA 98685 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $2K | $4K | 4.36% |
| ROXANA BUSCHMAN3 Filed as: ROXANA BUSCHMAN & OTHER AGENTS | 400 NE 149TH STREET VANCOUVER, WA 98685 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $150 | $2K | 2.47% |
| BENEFITS BY DESIGN INC3 Filed as: BENEFITS BY DESIGN, INC. | 2101 NE 279TH STREET RIDGEFIELD, WA 98642 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $456 | $2K | 2.25% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHWEST, LLC | PO BOX 2158 RIVERSIDE, CA 92516 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $0 | $1K | 1.58% |
| DAVID KINNEY3 | 802 NEVADA DRIVE LONGVIEW, WA 98632 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $867 | $261 | $1K | 1.35% |
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 | 163 | 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) | 163 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 424 | $199K |
| Vision | PRINCIPAL LIFE INSURANCE COMPANY | 424 | $199K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 424 | $199K |
| Short-term disability | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 101 | $84K |
| Other | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 101 | $84K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 424 | — |
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.