| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CHRISTINE LYNN MORGESTER3 | 2137 N Q STREET WASHOUGAL, WA 98671 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $244 | $66 | $310 | 17.75% |
| HEARTSEASE LLC3 Filed as: HEARTSEASE, LLC | 1521 NE 63RD AVE HILLSBORO, OR 97124 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $181 | $113 | $294 | 16.84% |
| PREMIER WORKSITE SOLUTIONS INC3 Filed as: PREMIER WORKSITE SOLUTIONS, INC. | 806 NW 79TH STREET VANCOUVER, WA 98665 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $86 | $71 | $157 | 8.99% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $134 | — | $134 | 7.67% |
| BENEFITS BY DESIGN INC3 Filed as: BENEFITS BY DESIGN, INC. | 2101 NE 279TH STREET RIDGEFIELD, WA 98642 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $83 | $47 | $130 | 7.45% |
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 | 103 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 106 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | REGENCE BLUECROSS BLUESHIELD OF OREGON | 177 | $977K |
| Dental | OREGON DENTAL SERVICE | 183 | $87K |
| Vision | REGENCE BLUECROSS BLUESHIELD OF OREGON | 177 | $977K |
| Life insurance | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 78 | $2K |
| Short-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 79 | $6K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 79 | $8K |
| Prescription drug | REGENCE BLUECROSS BLUESHIELD OF OREGON | 177 | $977K |
| Other(3 contracts, 3 carriers) | RELIANT BEHAVIORAL HEALTH, LLC | 159 | $7K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 183 | — |
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 comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.