| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PCF INSURANCE SERVICES OF THE WEST3 | 412 JEFFERSON PARKWAY SUITE 203 LAKE OSWEGO, OR 97035 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $6K | $0 | $6K | 10.00% |
| PCF INSURANCE SERVICES OF THE WEST3 | 7150 SW HAMPTON STREET SUITE 140 TIGARD, OR 97223 | EYEMED VISION CARE ON BEHALF OF THE FIDELITY INSURANCE COMPANY | $373 | $0 | $373 | 5.05% |
| PCF INSURANCE SERVICES OF THE WEST3 | 412 JEFFERSON PARKWAY SUITE 203 LAKE OSWEGO, OR 97035 | EYEMED VISION CARE ON BEHALF OF THE FIDELITY INSURANCE COMPANY | $364 | $0 | $364 | 4.93% |
| MARGARET BRYANT3 | 18014 BELMORE AVENUE LAKE OSWEGO, OR 97035 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $56 | $0 | $56 | 2.72% |
| PCF INSURANCE SERVICES OF THE WEST3 | 412 JEFFERSON PARKWAY SUITE 203 LAKE OSWEGO, OR 97035 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $37 | $0 | $37 | 1.80% |
| KAREN CLAY KUNKLER3 | 415 SE 177TH AVENUE UNIT 236 VANCOUVER, WA 98683 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $30 | $0 | $30 | 1.46% |
| HEARTSEASE LLC3 Filed as: HEARTSEASE, LLC. | 1521 NE 63RD AVENUE HILLSBORO, OR 97124 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $15 | $0 | $15 | 0.73% |
| WORKSITE BENEFITS GROUP INC3 Filed as: WORKSITE BENEFITS GROUP, INC. | 112 NW 114TH STREET VANCOUVER, WA 98685 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $15 | $0 | $15 | 0.73% |
| USI INSURANCE SERVICES LLC3 Filed as: KIBBLE AND PRENTICE HOLDING COMPANY | 601 UNION STREET SEATTLE, WA 98101 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $13 | $0 | $13 | 0.63% |
| ZINA OSTER3 | 3153 FOREST DRIVE CHEYENNE, WY 82001 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3 | $0 | $3 | 0.15% |
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 | 135 | 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) | 135 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITEDHEALTHCARE INSURANCE COMPANY | 123 | $632K |
| Dental | UNITED OF OMAHA LIFE INSURANCE COMPANY | 135 | $61K |
| Vision | EYEMED VISION CARE ON BEHALF OF THE FIDELITY INSURANCE COMPANY | 94 | $7K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 135 | $61K |
| Short-term disability | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 1 | $2K |
| Prescription drug | UNITEDHEALTHCARE INSURANCE COMPANY | 123 | $632K |
| Other(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 135 | $63K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 135 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.