| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| M&G3 | — | OREGON DENTAL SERVICES DBA DELTA DENTAL PLAN OF OREGON | $2K | — | $2K | 5.00% |
| MONTGOMERY & GRAHAM INC3 | 412 JEFFERSON PKWY STE 100 LAKE OSWEGO, OR 97035 | METROPOLITAN LIFE INSURANCE COMPANY | $1K | — | $1K | 14.81% |
| MONTGOMERY & GRAHAM INC3 Filed as: MONTGOMERY & GRAHAM BENEFITS | 412 JEFFERSON PARKWAY #100 LAKE OSWEGO, OR 97035 | EYEMED VISION CARE | $706 | — | $706 | 9.98% |
| MONTGOMERY & GRAHAM INC3 Filed as: MONTGOMERY AND GRAHAM INC | 412 JEFFERSON PKWY LAKE OSWEGO, OR 97035 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $860 | $255 | $1K | 23.15% |
| MARGARET BRYANT3 | 18014 SW BELMORE AVE LAKE OSWEGO, OR 97035 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $233 | $141 | $374 | 7.76% |
| KAREN CLAY KUNKLER3 | 1709 NW 45TH AVENUE CAMAS, WA 98607 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $231 | $29 | $260 | 5.40% |
| PREMIER WORKSITE SOLUTIONS INC3 | 112 NW 114TH ST VANCOUVER, WA 98685 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $79 | $77 | $156 | 3.24% |
| USI INSURANCE SERVICES LLC3 Filed as: KIBBLE & PRENTICE HOLDING COMPANY | 601 UNION STREET SEATTLE, WA 98101 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $53 | — | $53 | 1.10% |
| HEARTSEASE LLC3 | 1521 NE 63RD AVE HILLSBORO, OR 97124 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $51 | — | $51 | 1.06% |
| CHRISTINE LYNN MORGESTER3 | 988 SW 26TH ST TROUTDALE, OR 97060 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $20 | — | $20 | 0.42% |
| BENEFITS BY DESIGN INC3 | 2101 NE 279TH ST RIDGEFIELD, WA 98642 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $17 | — | $17 | 0.35% |
| SUSAN J LEACH3 | 4419 NE 131ST PLACE PORTLAND, OR 97230 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $12 | — | $12 | 0.25% |
| ZINA OSTER3 | 3153 FOREST DR CHEYENNE, WY 82001 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3 | — | $3 | 0.06% |
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 | 146 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 146 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 107 | $194K |
| Dental | OREGON DENTAL SERVICES DBA DELTA DENTAL PLAN OF OREGON | 107 | $34K |
| Vision | EYEMED VISION CARE | 92 | $7K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 146 | $8K |
| Other(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 146 | $13K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 146 | — |
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.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.