| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MONTGOMERY & GRAHAM INC3 | 412 JEFFERSON PARKWAY SUITE 100 LAKE OSWEGO, OR 97035 | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | — | $397 | $397 | 0.08% |
| MONTGOMERY & GRAHAM INC3 | 412 JEFFERSON PARKWAY SUITE 100 LAKE OSWEGA, OR 97035 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | — | $4K | 10.00% |
| MONTGOMERY & GRAHAM INC3 | 412 JEFFERSON PARKWAY SUITE 100 LAKE OSWEGA, OR 97035 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | — | $1K | 10.00% |
| MONTGOMERY & GRAHAM INC3 Filed as: MONTGOMERY & GRAHAM BENEFITS | 412 JEFFERSON PARKWAY #100 LAKE OSWEGO, OR 97035 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $855 | — | $855 | 11.54% |
| MARGARET BRYANT3 | 18014 SOUTHWEST BELMORE AVENUE LAKE OSWEGO, OR 97035 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $148 | $39 | $187 | 5.63% |
| KAREN CLAY KUNKLER3 | 1709 NORTHWEST 45TH AVENUE CAMAS, WA 98607 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $129 | $41 | $170 | 5.12% |
| MONTGOMERY & GRAHAM INC3 | 412 JEFFERSON PARKWAY LAKE OSWEGO, OR 97035 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $103 | $6 | $109 | 3.28% |
| WORKSITE BENEFITS GROUP INC3 | 112 NORTHWEST 114TH STREET VANCOUVER, WA 98685 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $49 | $41 | $90 | 2.71% |
| USI INSURANCE SERVICES LLC3 Filed as: KIBBLE & PRENTICE HOLDING COMPANY | 601 UNION STREET SEATTLE, WA 98101 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $42 | — | $42 | 1.27% |
| HEARTSEASE LLC3 | 1521 NORTHEAST 63RD AVENUE HILLSBORO, OR 97124 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $41 | — | $41 | 1.24% |
| CHRISTINE LYNN MORGESTER3 | 14913 SOUTH SUNTERRA LOOP OREGON CITY, OR 97045 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $22 | — | $22 | 0.66% |
| BENEFITS BY DESIGN INC3 | 2101 NORTHEAST 279TH STREET RIDGEFIELD, WA 98642 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $12 | — | $12 | 0.36% |
| ZINA OSTER3 | 3153 FOREST DRIVE CHEYENNE, WY 82001 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3 | — | $3 | 0.09% |
| MONTGOMERY & GRAHAM INC3 | 412 JEFFERSON PARKWAY SUITE 100 LAKE OSWEGO, OR 97035 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $276 | — | $276 | 10.01% |
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 | 108 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 110 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | 113 | $503K |
| Dental | UNITED OF OMAHA LIFE INSURANCE COMPANY | 75 | $39K |
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY | 92 | $7K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 108 | $14K |
| Short-term disability | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 4 | $3K |
| Other(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 108 | $14K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 113 | — |
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.