| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HEARTSEASE LLC3 Filed as: HEARTSEASE, LLC | 1521 NE 63RD AVENUE HILLSBORO, OR 97124 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $16K | $8K | $24K | 9.77% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NORTHWEST | 601 UNION STREET, SUITE 1000 SEATTLE, WA 98101 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $22K | $0 | $22K | 9.22% |
| WORKSITE BENEFITS GROUP INC3 Filed as: WORKSITE BENEFITS GROUP, INC. | 112 NW 114TH STREET VANCOUVER, WA 98685 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $4K | $5K | $9K | 3.59% |
| BENEFITS BY DESIGN INC3 Filed as: BENEFITS BY DESIGN, INC. | 2101 NE 279TH STREET RIDGEFIELD, WA 98642 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $5K | $2K | $7K | 3.01% |
| NICHOLAS J WOOG3 Filed as: NICHOLAS J WOOG & OTHER AGENTS | 4837 42ND AVENUE SOUTH SEATTLE, WA 98118 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $6K | $1K | $7K | 2.90% |
| ISAACSON INSURANCE AGENCY LLC3 Filed as: ISAACSON INSURANCE AGENCY, LLC | 1250 11TH STREET WEST LINN, OR 97068 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $4K | $1K | $6K | 2.37% |
| DAVID KINNEY3 | 802 NEVADA DRIVE LONGVIEW, WA 98632 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $4K | $904 | $5K | 2.15% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NORTHWEST | 601 UNION STREET, SUITE 1000 SEATTLE, WA 98101 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $10K | $0 | $10K | 9.05% |
| HEARTSEASE LLC3 Filed as: HEARTSEASE, LLC | 1521 NE 63RD AVENUE HILLSBORO, OR 97124 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $6K | $2K | $8K | 7.33% |
| ISAACSON INSURANCE AGENCY LLC3 Filed as: ISAACSON INSURANCE AGENCY & AGENTS | 1250 11TH STREET WEST LINN, OR 97068 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $4K | $629 | $4K | 3.91% |
| WORKSITE BENEFITS GROUP INC3 Filed as: WORKSITE BENEFITS GROUP, INC. | 112 NW 114TH STREET VANCOUVER, WA 98685 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $1K | $3K | 2.80% |
| BENEFITS BY DESIGN INC3 Filed as: BENEFITS BY DESIGN, INC. | 2101 NE 279TH STREET RIDGEFIELD, WA 98642 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $603 | $3K | 2.38% |
| DAVID KINNEY3 | 802 NEVADA DRIVE LONGVIEW, WA 98632 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $323 | $2K | 1.69% |
| RAQUEL LOSADA MONROY3 | 817 NE DELP ROAD CAMAS, WA 98607 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $123 | $1K | 1.09% |
| HEARTSEASE LLC3 Filed as: HEARTSEASE, LLC | 1521 NE 63RD AVENUE HILLSBORO, OR 97124 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $762 | $2K | 10.36% |
| 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 | 9.64% |
| WORKSITE BENEFITS GROUP INC3 Filed as: WORKSITE BENEFITS GROUP, INC. | 112 NW 114TH STREET VANCOUVER, WA 98685 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $508 | $606 | $1K | 4.98% |
| DAVID KINNEY3 Filed as: DAVID KINNEY AND OTHER AGENTS | 802 NEVADA DRIVE LONGVIEW, WA 98632 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $816 | $109 | $925 | 4.14% |
| BENEFITS BY DESIGN INC3 Filed as: BENEFITS BY DESIGN, INC. | 2101 NE 279TH STREET RIDGEFIELD, WA 98642 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $555 | $200 | $755 | 3.38% |
| ISAACSON INSURANCE AGENCY LLC3 Filed as: ISAACSON INSURANCE AGENCY, LLC | 1250 11TH STREET WEST LINN, OR 97068 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $523 | $187 | $710 | 3.17% |
| CHRISTINE LYNN MORGESTER3 | 14913 SOUTH SUNTERRA LOOP OREGON CITY, OR 97045 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $374 | $21 | $395 | 1.77% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NORTHWEST | 601 UNION STREET, SUITE 1000 SEATTLE, WA 98101 | CONTINENTAL AMERICAN INSURANCE COMPANY | $23 | $0 | $23 | 1.19% |
| BRYAN P. JORAMO3 | 1001 LOMBARD AVENUE EVERETT, WA 98201 | CONTINENTAL AMERICAN INSURANCE COMPANY | $21 | $0 | $21 | 1.09% |
| ADAM J. WESTFALL3 | 700 NORTH HAYDEN ISLAND DRIVE SUITE 200 PORTLAND, OR 97217 | CONTINENTAL AMERICAN INSURANCE COMPANY | $6 | $0 | $6 | 0.31% |
| NATE JOHNSON3 | 11328 NE 51ST CIRCLE, APARTMENT 65 VANCOUVER, WA 98682 | CONTINENTAL AMERICAN INSURANCE COMPANY | $5 | $0 | $5 | 0.26% |
| DEREK SOMMERS3 Filed as: DEREK W. SOMMERS | 518 NORTH 39TH PLACE RIDGEFIELD, WA 98642 | CONTINENTAL AMERICAN INSURANCE COMPANY | $3 | $0 | $3 | 0.16% |
| THOMAS CHAMBERS3 | 3945 SW 96TH AVENUE PORTLAND, OR 97225 | CONTINENTAL AMERICAN INSURANCE COMPANY | $2 | $0 | $2 | 0.10% |
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 | 301 | 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) | 301 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITEDHEALTHCARE INSURANCE COMPANY | 707 | $4.3M |
| Dental | WILLAMETTE DENTAL INSURANCE, INC. | 204 | $69K |
| Vision | VISION SERVICE PLAN | 323 | $54K |
| Life insurance(3 contracts) | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 229 | $373K |
| Short-term disability(4 contracts, 2 carriers) | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 229 | $374K |
| Prescription drug | UNITEDHEALTHCARE INSURANCE COMPANY | 707 | $4.3M |
| Other(4 contracts, 2 carriers) | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 229 | $374K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 707 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.