| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NORTHWEST | 601 UNION STREET, SUITE 1000 SEATTLE, WA 98101 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $20K | $0 | $20K | 8.63% |
| HEARTEASE LLC3 Filed as: HEARTEASE, LLC | 1521 NE 63RD AVENUE HILLSBORO, OR 97124 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $9K | $3K | $12K | 5.03% |
| WORKSITE BENEFITS GROUP INC3 Filed as: WORKSITE BENEFITS GROUP, INC. | 112 NW 114TH STREET VANCOUVER, WA 98685 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $3K | $3K | $6K | 2.55% |
| ISAACSON INSURANCE AGENCY LLC3 Filed as: ISAACSON INSURANCE AGENCY, LLC | 1250 11TH STREET WEST LINN, OR 97068 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $3K | $656 | $4K | 1.70% |
| BENEFITS BY DESIGN INC3 Filed as: BENEFITS BY DESIGN, INC. | 2101 NE 279TH STREET RIDGEFIELD, WA 98642 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $3K | $583 | $4K | 1.66% |
| RAQUEL LOSADA MONROY3 Filed as: RAQUEL MONROY AND OTHER AGENTS | 817 NE DELP ROAD CAMAS, WA 98607 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $481 | $3K | 1.28% |
| DAVID KINNEY3 | 802 NEVADA DRIVE LONGVIEW, WA 98632 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $523 | $3K | 1.11% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NORTHWEST | 601 UNION STREET, SUITE 1000 SEATTLE, WA 98101 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $9K | $0 | $9K | 8.48% |
| HEARTEASE LLC3 Filed as: HEARTEASE, LLC | 1521 NE 63RD AVENUE HILLSBORO, OR 97124 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $4K | $902 | $5K | 4.31% |
| WORKSITE BENEFITS GROUP INC3 Filed as: WORKSITE BENEFITS GROUP, INC. | 112 NW 114TH STREET VANCOUVER, WA 98685 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $1K | $2K | 1.98% |
| RAQUEL LOSADA MONROY3 Filed as: RAQUEL MONROY AND OTHER AGENTS | 817 NE DELP ROAD CAMAS, WA 98607 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $127 | $2K | 1.62% |
| BENEFITS BY DESIGN INC3 Filed as: BENEFITS BY DESIGN, INC. | 2101 NE 279TH STREET RIDGEFIELD, WA 98642 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $183 | $2K | 1.43% |
| ISAACSON INSURANCE AGENCY LLC3 Filed as: ISAACSON INSURANCE AGENCY, LLC | 1250 11TH STREET WEST LINN, OR 97068 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $241 | $1K | 1.18% |
| DAVID KINNEY3 | 802 NEVADA DRIVE LONGVIEW, WA 98632 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $463 | $94 | $557 | 0.52% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NORTHWEST | 601 UNION STREET, SUITE 1000 SEATTLE, WA 98101 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $0 | $2K | 8.37% |
| HEARTEASE LLC3 Filed as: HEARTEASE, LLC | 1521 NE 63RD AVENUE HILLSBORO, OR 97124 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $998 | $317 | $1K | 5.42% |
| WORKSITE BENEFITS GROUP INC3 Filed as: WORKSITE BENEFITS GROUP, INC. | 112 NW 114TH STREET VANCOUVER, WA 98685 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $296 | $420 | $716 | 2.95% |
| ISAACSON INSURANCE AGENCY LLC3 Filed as: ISAACSON INSURANCE AGENCY, LLC | 1250 11TH STREET WEST LINN, OR 97068 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $375 | $75 | $450 | 1.85% |
| BENEFITS BY DESIGN INC3 Filed as: BENEFITS BY DESIGN, INC. | 2101 NE 279TH STREET RIDGEFIELD, WA 98642 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $368 | $69 | $437 | 1.80% |
| DAVID KINNEY3 | 802 NEVADA DRIVE LONGVIEW, WA 98632 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $301 | $95 | $396 | 1.63% |
| RAQUEL LOSADA MONROY3 Filed as: RAQUEL MONROY AND OTHER AGENTS | 817 NE DELP ROAD CAMAS, WA 98607 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $328 | $64 | $392 | 1.61% |
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 | 334 | 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) | 334 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITEDHEALTHCARE INSURANCE COMPANY | 453 | $5.9M |
| Dental | WILLAMETTE DENTAL INSURANCE, INC. | 192 | $67K |
| Vision | VISION SERVICE PLAN | 355 | $60K |
| Life insurance(3 contracts) | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 220 | $360K |
| Short-term disability(3 contracts) | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 220 | $360K |
| Prescription drug | UNITEDHEALTHCARE INSURANCE COMPANY | 453 | $5.9M |
| Other(3 contracts) | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 220 | $360K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 453 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.